Document Detail

Captopril and atenolol are equally effective in retarding progression of diabetic nephropathy. Results of a 2-year prospective, randomized study.
MedLine Citation:
PMID:  7926346     Owner:  NLM     Status:  MEDLINE    
The progression of diabetic nephropathy can be positively influenced by maintaining a low blood pressure level. This has been shown in studies with conventional antihypertensive treatment as well as with ACE inhibitors. Whether the latter group of drugs is more effective remains to be proven and was the aim of our study. In a prospective randomized study we compared the effects of ACE inhibition and beta-blockade on retarding progression of renal function in IDDM patients with an early stage of overt diabetic nephropathy. Twenty-nine patients were studied for 2 years, 15 were randomized for treatment with captopril and 14 for atenolol. Every 6 weeks blood pressure and urinary albumin and total protein excretion were measured. GFR was measured every 6 months as 51Cr-EDTA clearance. Baseline values for blood pressure, renal function and albuminuria were identical in the two groups. The effect of both drugs on blood pressure was not significantly different. In the captopril-treated patients MAP before and after 2 years was 110 +/- 3 (SEM) and 100 +/- 2 mm Hg, respectively and in the atenolol-treated patients 105 +/- 2 vs 101 +/- 2 mm Hg. Both drugs reduced albuminuria and total proteinuria to the same extent. With captopril albuminuria decreased from 1549 (989-2399) to 851 (537-1380) mg/24 h and proteinuria from 2.5 (1.6-3.8) to 1.2 (0.8-1.8) g/24 h. With atenolol albuminuria decreased from 933 (603-1445) to 676 (437-1047) mg/24 h and proteinuria from 1.5 (1.0-2.4) to 0.9 (0.6-1.5) g/24 h.(ABSTRACT TRUNCATED AT 250 WORDS)
L D Elving; J F Wetzels; H J van Lier; E de Nobel; J H Berden
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Publication Detail:
Type:  Clinical Trial; Comparative Study; Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Diabetologia     Volume:  37     ISSN:  0012-186X     ISO Abbreviation:  Diabetologia     Publication Date:  1994 Jun 
Date Detail:
Created Date:  1994-10-25     Completed Date:  1994-10-25     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  0006777     Medline TA:  Diabetologia     Country:  GERMANY    
Other Details:
Languages:  eng     Pagination:  604-9     Citation Subset:  IM    
Department of Medicine, University Hospital Nijmegen, The Netherlands.
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MeSH Terms
Albuminuria / urine
Atenolol / therapeutic use*
Blood Pressure
Captopril / therapeutic use*
Diabetes Mellitus, Type 1 / drug therapy,  physiopathology,  urine
Diabetic Nephropathies / drug therapy*,  physiopathology,  urine
Glomerular Filtration Rate / drug effects
Prospective Studies
Proteinuria / urine
Treatment Outcome
Reg. No./Substance:
29122-68-7/Atenolol; 62571-86-2/Captopril
Comment In:
Diabetologia. 1995 Jan;38(1):123-4   [PMID:  7744219 ]

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