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Renoprotection from Angiotensin Inhibition: Evidence, Diabetic Use Grow

KEY POINT

Beneficial effects of angiotensin II receptor blockers (ARBs) in middle-aged and older patients with type 2 diabetes as demonstrated in three just-published studies confirm earlier evidence from retrospective analyses of studies of angiotensin-converting enzyme (ACE) inhibitors. As originally reported in ADIL in January 2000, virtually all middleaged or older patients with type 2 diabetes are candidates for angiotensin-blockade therapy, and the most recently published trials show ARBs to be effective for this use.

SOURCES

Lewis EJ et al. Renoprotective effect of the angiotensin-receptor antagonist irbesartan in patients with nephropathy due to type 2 diabetes. N Engl J Med. 2001;345:851–60.

Brenner BM et al. Effects of losartan on renal and cardiovascular outcomes in patients with type 2 diabetes and nephropathy. N Engl J Med. 2001;345:861–9.

Parving H-H et al. The effect of irbesartan on the development of diabetic nephropathy in patients with type 2 diabetes. N Engl J Med. 2001;345:870–8.

Hostetter TH. Prevention of end-stage renal disease due to type 2 diabetes [editorial]. N Engl J Med. 2001;345:910–2.

Huston P, Peterson R. Withholding proven treatment in clinical research [editorial]. N Engl J Med. 2001;345:912–4.