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COPYRIGHT 2003 International Medical News Group
Up to 40% of patients with type 2 diabetes develop nephropathy, and as many as 5%-7% develop end-stage renal disease. Diabetes is the leading cause of end-stage renal disease in the United States. Until recently, there wasn't much that a physician could do about nephropathy, but today a handful of drugs have Food and Drug Administration approval for protecting the kidney.
All of the drugs with this labeling block the renin-angiotensin system and fall into one of two closely related classes: the angiotensin-converting enzyme (ACE) inhibitors and the angiotensin receptor blockers (ARBs). Although head-to-head comparison studies have not been done, some experts believe that kidney protection is a class effect of all ACE inhibitors and ARBs. But not all agents in each class have been studied specifically for their nephroprotective effect.
The renal protection from ACE inhibitors and ARBs for patients with diabetes or nephropathy is convenient because many of these patients also have hypertension and these drugs, of course, also lower blood pressure. Recent guidelines from the American Diabetes Association (ADA) recommend that physicians use an ACE inhibitor as the initial drug in patients with hypertension who...
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