Dual renin-angiotensin system blockade at optimal doses for proteinuria

Dual renin-angiotensin system blockade for nephroprotection: still under scrutiny.

In experimental diabetic and non-diabetic chronic kidney disease (CKD), angiotensin-converting enzyme inhibitor (ACEi) and angiotensin receptor blocker (ARB) combination therapy reduces proteinuria and prevents structural lesions more effectively than either drug alone. Consistently, in humans, a multidrug individually tailored antiproteinuric treatment based on combination therapy with maximum...

Dual Blockade of the Renin-Angiotensin System in Diabetic Nephropathy

OBJECTIVE Many patients with diabetic nephropathy (DN) have levels of albuminuria > 1 g/day and blood pressure >135/85 mmHg, despite antihypertensive combination therapy, including recommended doses of ACE inhibitors, e.g., lisinopril/enalapril at 20 mg daily. We tested the concept that such patients might benefit from dual blockade of the renin-angiotensin system (RAS). RESEARCH DESIGN AND M...

Dual renin-angiotensin system blockade in heart failure.

Effect of Dual Blockade of Renin-Angiotensin Aldosterone System on Proteinuria in Patients with Diabetic Nephropathy and Advanced Azotemia

Purpose: To investigate the dual effect of angiotensin blockade by irbesartan and enalapril on proteinuria in diabetic patients with azotemia. Methods: Patients with diabetes of > 5 years duration, proteinuria at a nephrotic level and serum creatinine > 1.5 mg/dL were enrolled in the study. Forty-five enrolled patients were divided into three groups, those receiving enalapril , irbesartan, or e...

Blockade of the renin-angiotensin system.

HISTORICAL OVERVIEW Milestones in understanding the renin-angiotensin system (RAS) until the development of angiotensin II antagonists are described briefly. Sites at which the RAS might be blocked are outlined. PEPTIDE ANALOGUE ANTAGONISTS OF ANGIOTENSIN II RECEPTORS Saralasin-like compounds were used in numerous experimental and clinical situations and clarified the role of the RAS. Some of...