Seminars in Nephrology
Volume 24, Issue 2 , Pages 147-157 , March 2004

Angiotensin receptor blockers in diabetic nephropathy: renal and cardiovascular end points

  • Hans-Henrik Parving

      Affiliations

    • Steno Diabetes Center, Copenhagen, Denmark
    • Faculty of Health Science, University of Aarhus, Aarhus, Denmark
    • Corresponding Author InformationAddress reprint requests to Hans-Henrik Parving, MD, DMSc, Steno Diabetes Center, Niels Steensens Vej 2, DK-2820 Gentofte, Denmark
    • ,
  • Steen Andersen

      Affiliations

    • Steno Diabetes Center, Copenhagen, Denmark
    • ,
  • Peter Jacobsen

      Affiliations

    • Steno Diabetes Center, Copenhagen, Denmark
    • ,
  • Per K Christensen

      Affiliations

    • Steno Diabetes Center, Copenhagen, Denmark
    • ,
  • Kasper Rossing

      Affiliations

    • Steno Diabetes Center, Copenhagen, Denmark
    • ,
  • Peter Hovind

      Affiliations

    • Steno Diabetes Center, Copenhagen, Denmark
    • ,
  • Peter Rossing

      Affiliations

    • Steno Diabetes Center, Copenhagen, Denmark
    • ,
  • Lise Tarnow

      Affiliations

    • Steno Diabetes Center, Copenhagen, Denmark

References 

  1. Kussman MJ, Goldstein HH, Gleason RE. The clinical course of diabetic nephropathy. JAMA. 1976;236:1861–1863
  2. Parving H-H, Østerby R, Ritz E. Diabetic nephropathy. In:  Brenner BM editors. The Kidney. 6th ed.. Philadelphia: WB Saunders; 2000;p. 1731–1773
  3. Mogensen CE. Progression of nephropathy in long-term diabetics with proteinuria and effect of initial antihypertensive treatment. Scand J Clin Lab Invest. 1976;36:383–388
  4. Parving H-H, Smidt UM, Friisberg B, Bonnevie-Nielsen V, Andersen AR. A prospective study of glomerular filtration rate and arterial blood pressure in insulin-dependent diabetics with diabetic nephropathy. Diabetologia. 1981;20:457–461
  5. Borch-Johnsen K, Kreiner S. Proteinuria (Value as predictor of cardiovascular mortality in insulin dependent diabetes mellitus). BMJ. 1987;294:1651–1654
  6. Gall M-A, Borch-Johnsen K, Hougaard P, Nielsen FS, Parving H-H. Albuminuria and poor glycemic control predicts mortality in NIDDM. Diabetes. 1995;44:1303–1309
  7. Parving H-H, Hommel E. Prognosis in diabetic nephropathy. BMJ. 1989;299:230–233
  8. Mogensen CE. Long-term antihypertensive treatment inhibiting progression of diabetic nephropathy. BMJ. 1982;285:685–688
  9. Parving H-H, Andersen AR, Smidt UM, Svendsen PAa. Early aggressive antihypertensive treatment reduces rate of decline in kidney function in diabetic nephropathy. Lancet. 1983;i:1175–1179
  10. Lewis E, Hunsicker L, Bain R, Rhode R. The effect of angiotensin-converting-enzyme inhibition on diabetic nephropathy. N Engl J Med. 1993;329:1456–1462
  11. Parving H-H, Lehnert H, Bröchner-Mortensen J, Gomis R, Andersen S, Arner P. The effect of Irbesartan on the development of diabetic nephropathy in patients with type 2 diabetes. N Engl J Med. 2001;345:870–878
  12. Lewis EJ, Hunsicker LG, Clarke WR, et al.  Renoprotective effect of the angiotensin-receptor antagonist irbesartan in patients with nephropathy due to type 2 diabetes. N Engl J Med. 2001;345:851–860
  13. Brenner BM, Cooper ME, de Zeeuw D, Keane WF, Mitch WE, Parving H-H. Effects of Losartan on renal and cardiovascular outcomes in patients with type 2 diabetes and nephropathy. N Engl J Med. 2001;345:861–869
  14. Hovind P, Rossing P, Tarnow L, Smidt UM, Parving H-H. Remission and regression in the nephropathy of type 1 diabetes when blood pressure is controlled aggressively. Kidney Int. 2001;60:277–283
  15. Remuzzi G, Bertani T. Is glomerulosclerosis a consequence of altered glomerular permeability to macromolecules?. Kidney Int. 1990;38:384–394
  16. Rossing P. Promotion, prediction, and prevention of progression in diabetic nephropathy. Diabet Med. 1998;15:900–919
  17. Rossing P, Hommel E, Smidt UM, Parving H-H. Impact of arterial blood pressure and albuminuria on the progression of diabetic nephropathy in IDDM patients. Diabetes. 1993;42:715–719
  18. Peterson JC, Adler S, Burkart JM, et al.  Blood pressure control, proteinuria, and the progression of renal disease. The modification of diet in renal disease study. Ann Intern Med. 1995;123:754–762
  19. Keane WF, Brenner BM, de Zeeuw D, et al.  The risk of developing end-stage renal disease in patients with type 2 diabetes and nephropathy (the RENAAL study). Kidney Int. 2003;63:1499–1507
  20. Atkins RC, Briganti E, Wiegmann TB. Effect of baseline proteinuria and change in proteinuria with treatment on the risk of renal endpoints in the Irbesartan Diabetic Nephropathy Trial (IDNT). J Am Soc Nephrol. 2002;13:17A; (abstr)
  21. Rossing P, Hommel E, Smidt UM, Parving H-H. Reduction in albuminuria predicts a beneficial effect on diminishing the progression of human diabetic nephropathy during antihypertensive treatment. Diabetologia. 1994;37:511–516
  22. Apperloo AJ, de Zeeuw D, de Jong PE. Short-term antiproteinuric response to antihypertensive treatment predicts long-term GFR decline in patients with non-diabetic renal disease. Kidney Int. 1994;45(suppl 45):S174–S178
  23. The GISEN Group . Randomised placebo-controlled trial of effect of ramipril on decline in glomerular filtration rate and risk of terminal renal failure in proteinuric, non-diabetic nephropathy. Lancet. 1997;349:1857–1863
  24. Shahinfar S, Dickson TZ, Ahmed T, et al.  Losartan in patients with type 2 diabetes and proteinuria (Observations from the RENAAL study). Kidney Int Suppl. 2002;64–67
  25. Hovind P, Rossing P, Tarnow L, Smidt UM, Parving H-H. Progression of diabetic nephropathy. Kidney Int. 2001;59:702–709
  26. de Jong PE, Navis GJ, de Zeeuw D. Renoprotective therapy (Titration against urinary protein excretion). Lancet. 1999;354:352–353
  27. Muirhead N, Feagan B, Mahon J, et al.  The effects of valsartan and captopril on reducing microalbuminuria in patients with type 2 diabetes mellitus (A placebo-controlled trial). Current Therapeutic Research. 2002;60:650–660
  28. Lacourciere Y, Belanger A, Godin C, et al.  Long-term comparison of Losartan and enalapril on kidney function in hypertensive type 2 diabetics with early nephropathy. Kidney Int. 2000;58:762–769
  29. Andersen S, Tarnow L, Rossing P, Hansen BV, Parving H-H. Renoprotective effects of angiotensin II receptor blockade in type 1 diabetic patients with diabetic nephropathy. Kidney Int. 2000;57:601–606
  30. Andersen S, Jacobsen P, Tarnow L, Rossing P, Juhl TR, Parving H-H. Time course of the antiproteinuric and antihypertensive effect of Losartan in diabetic nephropathy. Nephrol Dial Transplant. 2003;18:293–297
  31. Buter H, Navis G, Dullaart RP, de Zeeuw D, de Jong PE. Time course of the antiproteinuric and renal haemodynamic responses to losartan in microalbuminuric IDDM. Nephrol Dial Transplant. 2001;16:771–775
  32. Bos H, Andersen S, Rossing P, et al.  Role of patient factors in therapy resistance to antiproteinuric intervention in nondiabetic and diabetic nephropathy. Kidney Int. 2000;57:S32–S37
  33. Andersen S, Blouch K, Bialek J, Deckert M, Parving H-H, Myers BD. Glomerular permselectivity in early stages of overt diabetic nephropathy. Kidney Int. 2000;58:2129–2137
  34. Imanishi M, Yoshioka K, Konishi Y, et al.  Glomerular hypertension as one cause of albuminuria in type II diabetic patients. Diabetologia. 1999;42:999–1005
  35. Bonnet F, Cooper ME, Kawachi H, Allen TJ, Boner G, Cao Z. Irbesartan normalises the deficiency in glomerular nephrin expression in a model of diabetes and hypertension. Diabetologia. 2001;44:874–877
  36. Langham RG, Kelly DJ, Cox AJ, et al.  Proteinuria and the expression of the podocyte slit diaphragm protein, nephrin, in diabetic nephropathy (Effects of angiotensin converting enzyme inhibition). Diabetologia. 2002;45:1572–1576
  37. Peters H, Border WA, Noble NA. Targeting TGF overexpression in renal disease. Maximizing the antifibrotic action of angiotensin II blockade. Kidney Int. 2000;54:1570–1580
  38. Rossing K, Christensen PK, Hansen BV, Carstensen B, Parving H-H. Optimal dose of Candesartan for renoprotection in type 2 diabetic patients with nephropathy (A double-blind randomized crossover study). Diabetes Care. 2003;26:150–155
  39. Andersen S, Rossing P, Juhl TR, Deinum J, Parving H-H. Optimal dose of losartan for renoprotection in diabetic nephropathy. Nephrol Dial Transplant. 2002;17:1413–1418
  40. Hilgers KF, Mann JF. ACE inhibitors versus AT(1) receptor antagonists in patients with chronic renal disease. J Am Soc Nephrol. 2002;13:1100–1108
  41. Cao Z, Bonnet F, Candido R, et al.  Angiotensin type 2 receptor antagonism confers renal protection in a rat model of progressive renal injury. J Am Soc Nephrol. 2002;13:1773–1787
  42. Komine N, Khang S, Wead LM, Blantz RC, Gabbai FB. Effect of combining an ACE inhibitor and an angiotensin II receptor blocker on plasma and kidney tissue angiotensin II levels. Am J Kidney Dis. 2002;39:159–164
  43. Mogensen CE, Neldam S, Tikkanen I, et al.  Randomised controlled trial of dual blockade of renin-angiotensin system in patients with hypertension, microalbuminuria, and non-insulin dependent diabetes (the candesartan and lisinopril microalbuminuria (CALM) study). BMJ. 2000;321:1440–1444
  44. Agarwal R. Add-on angiotensin receptor blockade with maximized ACE inhibition. Kidney Int. 2001;59:2282–2289
  45. Rossing K, Christensen PK, Jensen BR, Parving H-H. Dual blockade of the renin-angiotensin system in diabetic nephropathy (a randomized double-blind crossover study). Diabetes Care. 2002;25:95–100
  46. Jacobsen P, Andersen S, Rossing K, Hansen BV, Parving H-H. Dual blockade of the renin-angiotensin system in type 1 patients with diabetic nephropathy. Nephrol Dial Transplant. 2002;17:1019–1024
  47. Jacobsen P, Andersen S, Jensen BR, Parving H-H. Additive effect of ACE-inhibition and angiotensin II receptor blockade in type I diabetic patients with diabetic nephropathy. J Am Soc Nephrol. 2003;14:992–999
  48. Jacobsen P, Andersen S, Rossing K, Jensen BR, Parving H-H. Dual blockade of the renin-angiotensin system versus maximal recommended dose of ACE inhibition in diabetic nephropathy. Kidney Int. 2003;63:1874–1880
  49. Rossing K, Jacobsen P, Pietraszek L, Parving H-H. Renoprotective effects of adding angiotensin II receptor blocker to maximal recommended doses of ACE-inhibitor in diabetic nephropathy. A randomized double-blind cross-over trial. Diabetes Care. 2003;26:2268–2274
  50. Nakao N, Yoshimura A, Morita H, Takada M, Kayano T, Ideura T. Combination treatment of angiotensin-II receptor blocker and angiotensin-converting-enzyme inhibitor in non-diabetic renal disease (COOPERATE) (A randomised controlled trial). Lancet. 2003;361:117–124
  51. Palmer BF. Renal dysfunction complicating the treatment of hypertension. N Engl J Med. 2002;347:1256–1261
  52. Parving H-H, Kastrup J, Smidt UM, Andersen AR, Feldt-Rasmussen B, Christiansen JS. Impaired autoregulation of glomerular filtration rate in type 1 (insulin-dependent) diabetic patients with nephropathy. Diabetologia. 1984;27:547–552
  53. Christensen PK, Hansen HP, Parving H-H. Impaired autoregulation of GFR in hypertensive non-insulin dependent diabetic patients. Kidney Int. 1997;52:1369–1374
  54. Christensen PK, Lund S, Parving H-H. Autoregulated glomerular filtration rate during candesartan treatment in hypertensive type 2 diabetic patients. Kidney Int. 2001;60:1435–1442
  55. Christensen PK, Akram K, Konig KB, Parving H-H. Autoregulation of glomerular filtration rate in patients with type 2 diabetes during isradipine therapy. Diabetes Care. 2003;26:156–162
  56. Parving H-H, Jacobsen P, Tarnow L, et al.  Effect of deletion polymorphism of angiotensin converting enzyme gene on progression of diabetic nephropathy during inhibition of angiotensin converting enzyme (observational follow up study). BMJ. 1996;313:591–594
  57. Jacobsen P, Rossing K, Rossing P, et al.  Angiotensin converting enzyme gene polymorphism and ACE inhibition in diabetic nephropathy. Kidney Int. 1998;53:1002–1006
  58. Penno G, Chaturvedi N, Talmud PJ, et al.  Effect of angiotensin-converting enzyme (ACE) gene polymorphism on progression of renal disease and the influence of ACE inhibition in IDDM patients: Findings from the EUCLID Randomized Controlled Trial. EURODIAB Controlled Trial of Lisinopril in IDDM. Diabetes. 1998;47:1507–1511
  59. Jacobsen P, Tarnow L, Carstensen B, Hovind P, Poirier O, Parving H-H. Genetic variation in the renin-angiotensin system and progression of diabetic nephropathy. J Am Soc Nephrol. 2003;19:2843–2850
  60. Andersen S, Tarnow L, Cambien F, et al.  Long-term renoprotective effects of Losartan in diabetic nephropathy (Interaction with ACE insertion/deletion genotype?). Diabetes Care. 2002;26:1501–1506
  61. Andersen S, Tarnow L, Cambien F, et al.  Renoprotective effects of losartan in diabetic nephropathy (Interaction with ACE insertion/deletion genotype?). Kidney Int. 2002;62:192–198
  62. Parving H-H. Renoprotection in diabetes (Genetic and non-genetic risk factors and treatment). Diabetologia. 1998;41:745–759
  63. Rossing K, Christensen PK, Andersen S, Hovind P, Hansen HP, Parving H-H. Comparative effects of Irbesartan on ambulatory and office blood pressure (A substudy of ambulatory blood pressure from the Irbesartan in Patients with Type 2 Diabetes and Microalbuminuria Study). Diabetes Care. 2003;26:569–574
  64. Andersen S, Brochner-Mortensen J, Parving H-H. Kidney function after withdrawal of long-term antihypertensive treatment in patients with type 2 diabetes and microalbuminuria. Diabetes Care. 2003;26:3296–3302
  65. Gerth WC, Remuzzi G, Viberti G, et al.  Losartan reduces the burden and cost of ESRD (Public health implications from the RENAAL study for the European Union). Kidney Int. 2002;62(suppl 82):68–72
  66. de Zeeuw D, Remuzzi G, Parving H-H, et al.  Proteinuria reduction during antihypertensive therapy predicts renal and cardio-vascular protection in patients with type 2 diabetic nephropathy. Diabetologia. 2003;46(suppl 2):A339; abstr
  67. Berl T, Hunsicker LG, Lewis JB, et al.  Cardiovascular outcomes in the Irbesartan Diabetic Nephropathy Trial of Patients with Type 2 Diabetes and Overt Nephropathy. Ann Intern Med. 2003;138:542–549
  68. Pourdjabbar A, Lapointe N, Rouleau JL. Angiotensin receptor blockers (powerful evidence with cardiovascular outcomes?). Can J Cardiol. 2002;18(suppl A):7A–14A
  69. Dahlof B, Devereux RB, Kjeldsen SE, et al.  Cardiovascular morbidity and mortality in the Losartan Intervention For Endpoint reduction in hypertension study (LIFE) (A randomised trial against atenolol 2790). Lancet. 2002;359:995–1003
  70. Gaede P, Vedel P, Larsen N, Jensen GV, Parving H-H, Pedersen O. Multifactorial intervention and cardiovascular disease in patients with type 2 diabetes. N Engl J Med. 2003;348:383–393

PII: S0270-9295(03)00193-1

doi: 10.1016/j.semnephrol.2003.11.003

Seminars in Nephrology
Volume 24, Issue 2 , Pages 147-157 , March 2004

Article Tools

* Image Usage & Resolution