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Renoprotective Effects of Adding Angiotensin II Receptor Blocker to Maximal Recommended Doses of ACE Inhibitor in Diabetic Nephropathy

Table 1—

Effect of adding candesartan 16 mg o.d. to maximal recommended doses of ACEI (enalapril/lisinopril 40 mg daily) on kidney function and ABP in 20 patients with type 2 diabetes and diabetic nephropathy

ACEI + placebo ACEI + candesartan 16 mg Mean difference (95% CI)* P* value
Albuminuria (mg/24 h)† 706 (349–1,219) 508 (228–909) 28% (17–38) <0.001
Blood pressure (mmHg)
 24-h 138 (3)/72 (2) 135 (3)/70 (2) 3 (−2 to 8)/2 (−2 to 5) 0.21/0.38
 Day (7:00 a.m. to 11:00 p.m.) 142 (3)/74 (2) 139 (3)/72 (2) 3 (−2 to 7)/3 (−2 to 7) 0.32/0.31
 Night (11:00 p.m. to 7:00 a.m.) 131 (4)/67 (2) 126 (4)/65 (3) 5 (−2 to 11)/2 (−3 to 7) 0.16/0.51
GFR (ml · min−1 · 1.73 m−2) 77 (6) 74 (5) 4 (−1, 9) 0.10
Plasma creatinine (μmol/l) 121 (10) 123 (10) 2 (−7 to 10) 0.66
Plasma renin (mU/l) 42 (1) 53 (1) −24% (−60 to 12) 0.19
Plasma potassium (mmol/l) 4.0 (0.1) 4.2 (0.1) −0.13 (−0.3 to 0.1) 0.13
HbA1c (%) 7.9 (0.2) 8.1 (0.2) −0.1 (−0.1 to 0.4) 0.31
Cholesterol (mmol/l) 4.5 (0.2) 4.6 (0.2) −0.1 (−0.2 to 0.4) 0.60
Urinary sodium (mmol/24 h) 195 (13) 188 (12) 6 (−19 to 32) 0.63
Protein intake (g · kg−1 · 24 h−1) 0.92 (0.06) 0.93 (0.04) −0.01 (−0.07 to 0.07) 0.94

  • Data are means (SE).

  • *

    ↵* Mean difference of (ACEI + placebo) − (ACEI + candesartan 16 mg);

  • †

    ↵† geometric mean (IQR).

This Article

  1. Diabetes Care August 2003 vol. 26 no. 8 2268-2274
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