Nifedipine and enalapril equally reduce the progression of nephropathy in hypertensive type 2 diabetics
Nifedipine and enalapril equally reduce the progression of nephropathy in hypertensive type 2 diabetics
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DOI：
10.1016/s0168-8227(01)00288-1
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发表时间：
2001-12-01
影响因子：
5.1
通讯作者：
Baba, S
中科院分区：
文献类型：
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作者：
Baba, S
日本糖尿病肾病抗高血压治疗多中心研究（J-MIND）旨在评价硝苯地平缓释剂或依那普利对2型糖尿病高血压患者肾病的影响。共有436例正常白蛋白尿[尿白蛋白排泄率（AER）< 30 mg/d]或微量白蛋白尿[AER：30-300 mg/d]的患者随机接受硝苯地平缓释剂或依那普利治疗，并随访24个月。两组之间的基线特征无差异（平均AER分别为45和42 mg/天）。意向治疗分析显示，2年后AER无显著差异，尽管硝苯地平缓释剂组和依那普利组的平均AER分别增加至64和74 mg/d。正常白蛋白尿患者AER增加，而微量白蛋白尿患者AER无变化。在从正常白蛋白尿进展到微量白蛋白尿、从微量白蛋白尿进展到明显蛋白尿以及从微量白蛋白尿消退到正常白蛋白尿方面，两组之间没有差异。两组心血管事件的发生率也相似。总之，硝苯地平缓释剂和依那普利对无明显蛋白尿的高血压2型糖尿病患者的肾病有相似的影响。(C)2001爱思唯尔科学爱尔兰有限公司保留所有权利。
The Japan Multicenter Investigation of Antihypertensive Treatment for Nephropathy in Diabetics (J-MIND) study was conducted to evaluate the effect of nifedipine retard or enalapril on nephropathy in hypertensive patients with type 2 diabetes. A total of 436 patients with normoalbuminuria [urinary albumin excretion rate (AER) < 30 mg/day] or microalbuminuria [AER: 30-300 mg/day] were randomized to receive nifedipine retard or enalapril and were followed for 24 months. There were no differences in baseline characteristics between the two groups (the mean AER was 45 and 42 mg/day, respectively). Intent-to-treat analysis showed no significant difference in AER after 2 years, although the mean AER increased to 64 and 74 mg/day in the nifedipine retard and enalapril groups, respectively. The AER increased in patients with normoalbuminuria, whereas it did not change in those with microalbuminuria. There were no differences between the two groups with respect to progression from normoalbuminuria to microalbuminuria, progression from microalbuminuria to overt proteinuria, and regression from microalbuminuria to normoalbuminuria. The incidence of cardiovascular events was also similar in both groups, In conclusion, nifedipine retard and enalapril had a similar effect on nephropathy in hypertensive type 2 diabetic patients without overt proteinuria. (C) 2001 Elsevier Science Ireland Ltd. All rights reserved.