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Diabetes Care 30:1577-1578, 2007
DOI: 10.2337/dc06-1998
© 2007 by the American Diabetes Association
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Clinical Care/Education/Nutrition |
Prevention of Transition From Incipient to Overt Nephropathy With Telmisartan in Patients With Type 2 Diabetes
1 Department of Medicine and Clinical Science, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama, Japan
2 Department of Medicine, Division of Metabolism and Biosystemic Science, Asahikawa Medical College, Hokkaido, Japan
3 Division of Nephrology and Hypertension, Diabetes Center, Tokyo Women's Medical University School of Medicine, Tokyo, Japan
4 Department of Endocrinology, Diabetes, and Metabolism, Kitasato University School of Medicine, Kanagawa, Japan
5 Division of Nephrology, Tohoku University Graduate Medical School, Miyagi, Japan
6 Department of Medicine, Diabetes Center, Tokyo Women's Medical University School of Medicine, Tokyo, Japan
7 Department of Medicine, Medical School, Juntendo University, Tokyo, Japan
8 Division of Biostatistics, School of Pharmaceutical Sciences, Kitasato University, Tokyo, Japan
9 Division of Endocrinology and Diabetes, Department of Medicine, Saitama Medical School, Saitama, Japan
Address correspondence and reprint requests to Professor Hirofumi Makino, Department of Medicine and Clinical Science, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, 2-5-1 Shikata-cho, Okayama, Japan. E-mail: makino@md.okayama-u.ac.jp
Abbreviations: ARB, angiotensin receptor blocker • DBP, diastolic blood pressure • SBP, systolic blood pressure • UACR, urinary albumin-to-creatinine ratio
| The first 20% of the full text of this article appears below. |
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INTRODUCTION |
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To date, evidence for long-term renoprotection with angiotensin receptor blockers (ARBs) has come almost exclusively from Caucasian patients (1–3), despite Japanese people being at high risk of diabetic nephropathy and very susceptible to end-stage renal disease (4–6). We conducted the INNOVATION Study (Incipient to Overt: Angiotensin II Blocker, Telmisartan, Investigation on Type 2 Diabetic Nephropathy) to evaluate the efficacy of an ARB in preventing transition from microalbuminuria to overt nephropathy in Japanese patients (7). This study is the first large-scale clinical study to investigate prevention of overt diabetic nephropathy using an ARB in normotensive and hypertensive Japanese patients with type 2 diabetes.
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RESEARCH DESIGN AND METHODS— |
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The randomized, multicenter, double-blind, placebo-controlled trial was performed in patients aged from 30 to 74 years with type 2 diabetes and urinary albumin-to-creatinine ratio (UACR) 100–300 mg/g and serum creatinine <1.5 mg/dl (men) and <1.3 mg/dl (women). Exclusion criteria included type 1 diabetes, age of diabetes onset <30 years, seated systolic blood pressure (SBP)/diastolic blood pressure (DBP)
180/100 mmHg, and definable chronic kidney |
RESULTS— |
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CONCLUSIONS— |
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