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2016 ; 17
(3
): ä Nephropedia Template TP
gab.com Text
Twit Text FOAVip
Twit Text #
English Wikipedia
Prevention of microalbuminuria using early intervention with renin-angiotensin
system inhibitors in patients with type 2 diabetes: A systematic review
#MMPMID27488274
Persson F
; Lindhardt M
; Rossing P
; Parving HH
J Renin Angiotensin Aldosterone Syst
2016[Jul]; 17
(3
): ä PMID27488274
show ga
HYPOTHESIS/OBJECTIVES: Early prevention of diabetic nephropathy by way of
blocking the renin-angiotensin system (RAS) in patients with normoalbuminuria
seems rational, but trials have so far shown conflicting results. The present
meta-analysis was undertaken to investigate if such treatment can prevent
development of microalbuminuria. MATERIALS AND METHODS: We searched MEDLINE,
EMBASE and the Cochrane Library (2 June 2014) for randomised controlled trials,
with a population of patients with type 2 diabetes and normoalbuminuria,
comparing angiotensin-converting enzyme inhibitors (ACEis) or angiotensin
receptor blockers (ARBs) to placebo. Studies had to have at least 50 participants
in each arm and one year of follow-up. Random and fixed effect models were
performed as well as trial sequential analysis. RESULTS: Six trials were included
in the analysis (n=16,921). Overall risk of bias was variable. In a fixed model
analysis ACE or ARB treatment was superior to placebo in relation to prevention
of development of microalbuminuria, risk ratio 0.84 (95% confidence interval (CI)
0.79-0.88) p<0.001, I(2)=23%, similar to random model results. Treatment also
showed a trend towards a reduction in all-cause mortality(p=0.07). CONCLUSIONS:
We conclude that in patients with type 2 diabetes and normoalbuminuria, early
intervention with ACEis or ARBs reduces the risk for development of
microalbuminuria.
|*Renin-Angiotensin System
[MESH]
|Albuminuria/*complications/drug therapy/physiopathology/*prevention & control
[MESH]
|Angiotensin-Converting Enzyme Inhibitors/pharmacology/therapeutic use
[MESH]
|Blood Pressure/drug effects
[MESH]
|Clinical Trials as Topic
[MESH]
|Diabetes Mellitus, Type 2/*complications/*drug therapy/physiopathology
[MESH]