Forskning
Udskriv Udskriv
Switch language
Region Hovedstaden - en del af Københavns Universitetshospital
Udgivet

Dual blockade of the renin-angiotensin system in type 1 patients with diabetic nephropathy

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

DOI

  1. The dapagliflozin and prevention of adverse outcomes in chronic kidney disease (DAPA-CKD) trial: baseline characteristics

    Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

  2. Short-term effect of the New Nordic Renal Diet on phosphorus homoeostasis in chronic kidney disease Stages 3 and 4

    Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

  1. Gut microbiota profile and selected plasma metabolites in type 1 diabetes without and with stratification by albuminuria

    Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

  2. Profiling of gut microbiota and plasma metabolites in persons with type 1 diabetes and kidney disease

    Publikation: Bidrag til tidsskriftKonferenceabstrakt i tidsskriftForskningpeer review

  3. Long-Term Adverse Cardiac Outcomes in Patients With Sarcoidosis

    Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

  4. Pulmonary artery pressure as a method for assessing hydration status in an anuric hemodialysis patient - a case report

    Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

Vis graf over relationer

BACKGROUND: Albuminuria and hypertension are predictors of poor renal and cardiovascular outcome in patients with diabetes. Approximately 30% of type 1 patients with diabetic nephropathy (DN) have albuminuria >1 g/day, and blood pressure >135 and/or >85 mmHg despite antihypertensive therapy with recommended doses of ACE inhibitor (ACEI) and diuretics. We tested the effect of dual blockade of the renin-angiotensin system (RAS) in these patients.

METHODS: We performed a randomised double blind crossover trial with 2 months treatment with Irbesartan 300 mg o.d. and placebo added on top of previous antihypertensive treatment. We included 21 type 1 patients with DN responding insufficiently to ACEI and diuretics, as defined above. At the end of each treatment period, albuminuria, 24-h blood pressure and glomerular filtration rate (GFR) were measured.

RESULTS: Addition of 300 mg Irbesartan to the patients' usual antihypertensive therapy induced a mean reduction in albuminuria of 37% (95% CI 20-49, P<0.001); from 1574 mg/24 h (95% CI 1162-2132) to 996 mg/24 h (95% CI 699-1419), a reduction in 24-h blood pressure of 8 mmHg systolic (95% CI -2 to 18) and 5 mmHg diastolic (95% CI 1-9) (P=0.11 and 0.01, respectively) (from placebo, mean (SE) 146 (4)/80 (2) mmHg). GFR remained unchanged. Serum potassium increased (mean 4.3 to 4.6 mmol/l, P=0.02). Intervention to reduce serum potassium was needed in two patients with GFR <35 ml/min/1.73 m(2). Otherwise the dual blockade with Irbesartan was safe and well tolerated.

CONCLUSIONS: Dual blockade of the RAS may offer additional renal and cardiovascular protection in type 1 patients with DN responding insufficiently to conventional antihypertensive therapy, including recommended doses of ACEI and diuretics.

OriginalsprogEngelsk
TidsskriftNephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association
Vol/bind17
Udgave nummer6
Sider (fra-til)1019-24
Antal sider6
ISSN0931-0509
DOI
StatusUdgivet - jun. 2002

ID: 59053989