Complete Blockade of the Renin-Angiotensin System in Patients With Advanced Diabetic Nephropathy
- Javier Deira, MD, PHD,
- Hugo Diaz, MD and
- Jesús Grande, MD, PHD
- From the Division of Nephrology, Internal Medicine, Hosptial Virgen de la Concha, Zamora, Spain
We read with interest the article by Rossing et al. (1) in the January 2002 issue of Diabetes Care. We had previously assessed the effect of complete blockade of the renin-angiotensin system (RAS) in patients with advanced diabetic nephropathy (type 2 diabetes) and severe proteinuria (2). To do so, we studied 10 patients on prior treatment with ACE inhibitors at recommended doses, to which 50 mg/day of Losartan was added.
After 3 months of the combined therapy, urinary protein excretion decreased from a mean of 6.9 (95% CI 4.3–9.6) to 5.8 g/24 h (3–8.6) (P = 0.025) and, with the exception of two patients, was reduced in all cases. The …
