The Combined Effect of Angiotensin Converting Enzyme Inhibitors and Angiotensin Receptor Blockers on the Progressing of Kidney Disease in Patients With Type 2 Diabetes Compared to Single Administration of Each of These Two Drugs



Sanadgol H¹ ; Tamadon MR² ; Dashipour A³ ; Ghazanfari H⁴ ; Khodadadi S⁵ ; Nasri H⁶
Source: Journal of Isfahan Medical School Published:2016

Abstract

Background: Inhibition of the renin-angiotensin system in patients with diabetic nephropathy can reduce proteinuria and slow down renal impairment. In this study, we aimed to evaluate the preventive effects of prescribing both angiotensin converting enzyme inhibitors (ACEI) and angiotensin receptor inhibitors (ARBs) for renal disease progression compared with administrating each of these two medications alone in patients with type 2 diabetes. Methods: 90 patients with diabetic nephropathy were randomized into three groups: receiving captopril, losartan, and losartan in combination with captopril. Proteinuria was measured before, 2, 6 and 12 months after intervention, and creatinine clearance was measured before and after intervention. Repeated measures ANOVA, Fisher’s least significant difference (Fisher’s LSD), and t-test were used for data analysis by SPSS software. Findings: Proteinuria was improved in all groups who received medication (P < 0.001). This reduction in the group who received losartan in combined to captopril was more than other groups (P = 0.026). Creatinine clearance was not significantly different between all groups. Conclusion: Administration of ACEI or ARBs reduced proteinuria in patients suffering from diabetic nephropathy (due to type 2 diabetes) but prescribing both drugs had a significantly better outcome. However, creatinine clearance was not significantly improved in any of the groups. © 2016, Isfahan University of Medical Sciences(IUMS). All rights reserved.