Effects of Dual Blockade of the ReninAngiotensin System Compared to Single Drug Treatment in Renoprotection for Patients With Diabetes Mellitus Type II and Diabetic Nephropathy

Background: Monotherapy treatment with either angiotensin-converting enzyme inhibitors (ACE-Is) or angiotensin type I receptor antagonists (ARBs) has been shown to be renoprotective in patients with Diabetes Mellitus Type II (DM II). Dual blockade of the renin angiotensin system (RAS) with the combination of ACE-Is and ARBs in these same patients might provide further benefit. Methods: Exhaustive search of available medical literature using the search engines, Medline, CINAHL, and Science Citation Index Expanded. Articles were included which used multiple measurements of kidney function and patients with varying levels of kidney function. Results: After using the exclusion criteria, a collection of articles was narrowed to 6 studies. All articles proved a decrease in proteinuria and short term benefit in renal function. One article demonstrated long term harm to the kidneys. Conclusion: Dual blockade of RAS reveals short term improvement of renal function which in the long term might have adverse effects on the kidneys. In the future longer term studies should be done to prove or disprove the benefits on kidney health. If dual therapy is beneficial then providers will be able to prescribe ACE-Is and ARBs together to protect the kidneys in DM II patients. Degree Type Capstone Project Rights Terms of use for work posted in CommonKnowledge. This capstone project is available at CommonKnowledge: http://commons.pacificu.edu/pa/193 Copyright and terms of use If you have downloaded this document directly from the web or from CommonKnowledge, see the “Rights” section on the previous page for the terms of use. If you have received this document through an interlibrary loan/document delivery service, the following terms of use apply: Copyright in this work is held by the author(s). You may download or print any portion of this document for personal use only, or for any use that is allowed by fair use (Title 17, §107 U.S.C.). Except for personal or fair use, you or your borrowing library may not reproduce, remix, republish, post, transmit, or distribute this document, or any portion thereof, without the permission of the copyright owner. [Note: If this document is licensed under a Creative Commons license (see “Rights” on the previous page) which allows broader usage rights, your use is governed by the terms of that license. ] Inquiries regarding further use of these materials should be addressed to: CommonKnowledge Rights, Pacific University Library, 2043 College Way, Forest Grove, OR 97116, (503) 352-7209. Email inquiries may be directed to:. copyright@pacificu.edu This capstone project is available at CommonKnowledge: http://commons.pacificu.edu/pa/193 NOTICE TO READERS This work is not a peer-reviewed publication. The Master’s Candidate author of this work has made every effort to provide accurate information and to rely on authoritative sources in the completion of this work. However, neither the author nor the faculty advisor(s) warrants the completeness, accuracy or usefulness of the information provided in this work. This work should not be considered authoritative or comprehensive in and of itself and the author and advisor(s) disclaim all responsibility for the results obtained from use of the information contained in this work. Knowledge and practice change constantly, and readers are advised to confirm the information found in this work with other more current and/or comprehensive sources. The student author attests that this work is completely his/her original authorship and that no material in this work has been plagiarized, fabricated or incorrectly attributed.