Blood-Pressure Drugs Slow Diabetic Kidney Disease

Description And Advantages 

A class of drugs used to treat high blood pressure slows the progression of kidney disease in people with type 2 diabetes, according to the results of three clinical trials. The drugs, known as angiotensin-II-receptor blockers, are approved to treat high blood pressure, but their benefits to the kidney are independent of any effect on blood pressure.

Diabetic kidney disease, or nephropathy, has become the leading cause of kidney failure in Europe, Japan and the US. Eventually, about 40% of people with type 2 diabetes-the non-insulin- dependent form of the disease, which usually strikes in adulthood - develop kidney disease. 

Diabetic kidney disease results from the long-term effects of diabetes on tiny vessels within the kidney. Early signs include the build-up of  proteins in the urine and impaired kidney function. Eventually, diabetic kidney disease can lead to kidney failure. At this point, dialysis and kidney transplantation are the only treatment options.

Drugs called ACE inhibitors have been shown to slow kidney disease in people with type 1, (insulin- dependent) diabetes, but the best treatment for people with type 2 diabetes has been uncertain.

The results of the three new studies, published in the September 20th issue of The New England Journal of Medicine, suggest that angiotensin-II-receptor blockers may be a good choice for staving off kidney deterioration in patients with type 2 diabetes, although the studies did not directly compare the drugs to ACE inhibitors.

In one of the studies, a team led by Dr. Barry M. Brenner at Brigham and Women's Hospital in Boston, Massachusetts, compared the drug losartan (Cozaar) to an inactive placebo pill in more than 1,500 patients with type 2 diabetes who had already developed kidney disease.

During an average follow-up period of more than 3 years, patients taking losartan had a 28% lower risk of end-stage kidney disease than those on the placebo, Brenner and his colleagues report. Patients taking the drug also experienced a 25% decrease in blood levels of creatinine, which is a marker of kidney disease. 

Source: Chronicle Pharmabiz, 2001