Losartan for Microalbuminuria in Normotensive Type 2 Diabetes Mellitus
Authors: Adrienne A.M. Zandbergen
Journal: Annals of Internal Medicine (2004)

Letters20 April 2004Losartan for Microalbuminuria in Normotensive Type 2 Diabetes MellitusAdrienne A.M. Zandbergen, MD, Marinus G.A. Baggen, MD, PhD, and Rob J.Th. Ouwendijk, MD, PhDAdrienne A.M. Zandbergen, MDFrom Ikazia Hospital, 3083 AN Rotterdam, the Netherlands.Search for more papers by this author, Marinus G.A. Baggen, MD, PhDFrom Ikazia Hospital, 3083 AN Rotterdam, the Netherlands.Search for more papers by this author, and Rob J.Th. Ouwendijk, MD, PhDFrom Ikazia Hospital, 3083 AN Rotterdam, the Netherlands.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-140-8-200404200-00028 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail IN RESPONSE:Regarding Dr. Mandal's first statement, when we calculated creatinine clearance with the Cockcroft-Gault formula (which corrects for inaccuracy of urine collection), it decreased 3.3% in the losartan group and increased 2.7% in the placebo group; this difference was not statistically significant. Furthermore, as is known from previous long-term, large-scale studies, creatinine clearance stabilizes after prolonged treatment with ACE inhibitors or angiotensin-receptor antagonists (1-3). These agents have been shown to reduce the decline in GFR and to preserve kidney function.We agree that control of blood glucose is the most important factor in reducing the development and progression of ...References1. Mathiesen ER, Hommel E, Hansen HP, Smidt UM, Parving HH. Randomised controlled trial of long term efficacy of captopril on preservation of kidney function in normotensive patients with insulin dependent diabetes and microalbuminuria. BMJ. 1999;319:24-5. [PMID: 10390455] CrossrefMedlineGoogle Scholar2. Lewis EJ, Hunsicker LG, Clarke WR, Berl T, Pohl MA, Lewis JB, 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. [PMID: 11565517] CrossrefMedlineGoogle Scholar3. Brenner BM, Cooper ME, de Zeeuw D, Keane WF, Mitch WE, Parving HH, 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. [PMID: 11565518] CrossrefMedlineGoogle Scholar4. Rutter MK, Wahid ST, McComb JM, Marshall SM. Significance of silent ischemia and microalbuminuria in predicting coronary events in asymptomatic patients with type 2 diabetes. J Am Coll Cardiol. 2002;40:56-61. [PMID: 12103256] CrossrefMedlineGoogle Scholar5. Stehouwer CD, Nauta JJ, Zeldenrust GC, Hackeng WH, Donker AJ, den Ottolander GJ. Urinary albumin excretion, cardiovascular disease, and endothelial dysfunction in non–insulin-dependent diabetes mellitus. Lancet. 1992;340:319-23. [PMID: 1353802] CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAffiliations: From Ikazia Hospital, 3083 AN Rotterdam, the Netherlands. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoEffect of Losartan on Microalbuminuria in Normotensive Patients with Type 2 Diabetes Mellitus Adrienne A.M. Zandbergen , Marinus G.A. Baggen , Steven W.J. Lamberts , Aart H. Bootsma , Dick de Zeeuw , and Rob J.Th. Ouwendijk Losartan for Microalbuminuria in Normotensive Type 2 Diabetes Mellitus Anil K. Mandal Losartan for Microalbuminuria in Normotensive Type 2 Diabetes Mellitus Kazuomi Kario and Kazuyuki Shimada Metrics 20 April 2004Volume 140, Issue 8Page: 668-669KeywordsACE inhibitorsAlbuminsBlood pressureCreatinineExcretionGlucoseHemoglobinKidneysRenal diseasesType 2 diabetes ePublished: 20 April 2004 Issue Published: 20 April 2004 CopyrightCopyright © 2004 by American College of Physicians. All Rights Reserved.PDF DownloadLoading ...