Angiotensin-Receptor Blockers in the Prevention or Treatment of Microalbuminuria
Authors: Patrick S. Parfrey
Journal: Annals of Internal Medicine (2009)

Editorials7 July 2009Angiotensin-Receptor Blockers in the Prevention or Treatment of MicroalbuminuriaPatrick S. Parfrey, MDPatrick S. Parfrey, MDFrom Health Sciences Centre, Memorial University, St. John's, Newfoundland A1B 3V6, Canada.Author, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-151-1-200907070-00011 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail Type 1 and type 2 diabetes mellitus are the most frequent causes of end-stage renal disease in the United States (1). The natural history of diabetic nephropathy starts with microalbuminuria, which may progress to macroalbuminuria, gradual deterioration in glomerular filtration rate (GFR), and eventually end-stage kidney disease. Microalbuminuria in diabetes strongly predicts end-stage renal disease and adverse cardiovascular events (2–4). Although inhibitors of the renin–angiotensin system (RAS) have become the mainstays of treating established diabetic nephropathy (5), the role of these agents in the early phases of diabetic nephropathy is unclear. Kidney damage may occur in diabetics who do not ...References1. U.S. Renal Data System. USRDS 2007 Annual Data Report. Bethesda, MD: National Institute of Health, National Institute of Diabetes and Digestive and Kidney Disease; 2007. Google Scholar2. Viberti GC, Hill RD, Jarrett RJ, Argyropoulos A, Mahmud U, Keen H. Microalbuminuria as a predictor of clinical nephropathy in insulin-dependent diabetes mellitus. Lancet. 1982;1:1430-2. [PMID: 6123720] CrossrefMedlineGoogle Scholar3. Borch-Johnsen K, Kreiner S. Proteinuria: value as predictor of cardiovascular mortality in insulin dependent diabetes mellitus. Br Med J (Clin Res Ed). 1987;294:1651-4. [PMID: 3113569] CrossrefMedlineGoogle Scholar4. Dinneen SF, Gerstein HC. 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Renal outcomes with telmisartan, ramipril, or both, in people at high vascular risk (the ONTARGET study): a multicentre, randomised, double-blind, controlled trial. Lancet. 2008;372:547-53. [PMID: 18707986] CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAffiliations: From Health Sciences Centre, Memorial University, St. John's, Newfoundland A1B 3V6, Canada.Disclosures:Consultancies: Amgen, Ortho Biotech, Roche. Grants received: Amgen, Ortho Biotech, Merck & Co. Other: Dr. Parfrey has served with Dr. H.H. Parving, a DIRECT Steering Committee member, on the executive committee of a randomized, controlled trial funded by Amgen.Corresponding Author: Patrick S. Parfrey, MD, Health Sciences Centre, Memorial University, St. John's, Newfoundland A1B 3V6, Canada; e-mail, [email protected]ca. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoEffect of Telmisartan on Renal Outcomes Johannes F.E. Mann , Roland E. Schmieder , Leanne Dyal , Matthew J. McQueen , Helmut Schumacher , Janice Pogue , Xingyu Wang , Jeffrey L. Probstfield , Alvaro Avezum , Ernesto Cardona-Munoz , Gilles R. Dagenais , Rafael Diaz , George Fodor , Jean M. Maillon , Lars Rydén , Cheuk M. Yu , Koon K. Teo , Salim Yusuf , and Effect of Candesartan on Microalbuminuria and Albumin Excretion Rate in Diabetes Rudy Bilous , Nish Chaturvedi , Anne Katrin Sjølie , John Fuller , Ronald Klein , Trevor Orchard , Massimo Porta , and Hans-Henrik Parving Metrics Cited byAntihypertensive agents for preventing diabetic kidney diseaseContinuously Evolving Management Concepts for Diabetic CKD and ESRD 7 July 2009Volume 151, Issue 1Page: 63-65KeywordsACE inhibitorsCardiovascular diseasesCreatinineMedical dialysisMicroalbuminuriaRenal diseasesRetinopathyType 1 diabetesType 2 diabetesVascular diseases ePublished: 7 July 2009 Issue Published: 7 July 2009 Copyright & PermissionsCopyright © 2009 by American College of Physicians. 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