Regardless of baseline blood pressure, treatment with a combination of an angiotensin-converting enzyme inhibitor and a diuretic decreases incidence of renal events in patients with type 2 diabetes. The combination therapy approach could be the key to achieving renoprotection.
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References
Saran, A. M. & DuBose, T. D. Jr. Cardiovascular disease in chronic kidney disease. Ther. Adv. Cardiovasc. Dis. 2, 425–434 (2008).
Kolasinska-Malkowska, K., Filipiak, K. J., Gwizdala, A. & Tykarski, A. Current possibilities of ACE inhibitor and ARB combination in arterial hypertension and its complications. Expert Rev. Cardiovasc. Ther. 6, 759–771 (2008).
Heart Outcomes Prevention Evaluation (HOPE) Study Investigators. Effects of ramipril on cardiovascular and microvascular outcomes in people with diabetes mellitus: results of the HOPE study and MICRO-HOPE substudy. Lancet 355, 253–259 (2000).
Pohl, M. A. et al. Independent and additive impact of blood pressure control and angiotensin II receptor blockade on renal outcomes in the irbesartan diabetic nephropathy trial: clinical implications and limitations. J. Am. Soc. Nephrol. 16, 3027–3037 (2005).
de Galan, B. E. et al. Lowering blood pressure reduces renal events in type 2 diabetes. J. Am. Soc. Nephrol. 20, 883–892 (2009).
Patel, A. et al. Effects of a fixed combination of perindopril and indapamide on macrovascular and microvascular outcomes in patients with type 2 diabetes mellitus (the ADVANCE trial): a randomised controlled trial. Lancet 370, 829–840 (2007).
Chalmers, J., Joshi, R., Kengne, A. P. & MacMahon, S. Blood pressure lowering with fixed combination perindopril–indapamide: key findings from ADVANCE. J. Hypertens. 26 (Suppl. 2), S11–S15 (2008).
Gansevoort, R. T. & de Jong, P. E. The case for using albuminuria in staging chronic kidney disease. J. Am. Soc. Nephrol. 20, 465–468 (2009).
Gaede, P., Tarnow, L., Vedel, P., Parving, H. H. & Pedersen, O. Remission to normoalbuminuria during multifactorial treatment preserves kidney function in patients with type 2 diabetes and microalbuminuria. Nephrol. Dial. Transplant. 19, 2784–2788 (2004).
Marre, M. et al. Equivalence of indapamide SR and enalapril on microalbuminuria reduction in hypertensive patients with type 2 diabetes: the NESTOR Study. J. Hypertens. 22, 1613–1622 (2004).
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Suzuki, H. Renal benefits of lowering BP in the absence of hypertension. Nat Rev Nephrol 5, 370–371 (2009). https://doi.org/10.1038/nrneph.2009.92
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DOI: https://doi.org/10.1038/nrneph.2009.92
