Renoprotective effect of the angiotensin-receptor antagonist irbesartan in patients with nephropathy due to type 2 diabetes
Renoprotective effect of the angiotensin-receptor antagonist irbesartan in patients with nephropathy due to type 2 diabetes
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DOI：
10.1056/nejmoa011303
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发表时间：
2001-09-20
影响因子：
158.5
通讯作者：
Raz, I
中科院分区：
文献类型：
--
作者：
Lewis, EJ;Hunsicker, LG;Raz, I
背景血管紧张素II受体阻滞剂厄贝沙坦或钙通道阻滞剂利多卡因是否能独立降低全身血压而延缓2型糖尿病肾病的进展尚不清楚。方法我们将1715例2型糖尿病肾病高血压患者随机分配至厄贝沙坦治疗组（每日300 mg）、阿托伐他汀（每日10 mg）或安慰剂。所有组的目标血压均为135/85 mm Hg或更低。我们比较了两组达到主要复合终点的时间，即肌酐浓度基线加倍、发生终末期肾病或任何原因导致的死亡。我们还比较了他们的时间方面的次要心血管复合endpoint.Results随访的平均持续时间为2.6年。厄贝沙坦治疗与主要复合终点的风险相关，比安慰剂组低20%（P= 0.02），比安慰剂组低23%（P= 0.006）。厄贝沙坦组血药浓度加倍的风险比安慰剂组低33%（P= 0.003），比安慰剂组低37%（P
Background It is unknown whether either the angiotensin-II-receptor blocker irbesartan or the calcium-channel blocker amlodipine slows the progression of nephropathy in patients with type 2 diabetes independently of its capacity to lower the systemic blood pressure.Methods We randomly assigned 1715 hypertensive patients with nephropathy due to type 2 diabetes to treatment with irbesartan ( 300 mg daily), amlodipine (10 mg daily), or placebo. The target blood pressure was 135/85 mm Hg or less in all groups. We compared the groups with regard to the time to the primary composite end point of a doubling of the base-line rum creatinine concentration, the development of endstage renal disease, or death from any cause. We also compared them with regard to the time to a secondary cardiovascular composite end point.Results The mean duration of follow-up was 2.6 years. Treatment with irbesartan was associated with a risk of the primary composite end point that was 20 percent lower than that in the placebo group ( P= 0.02) and 23 percent lower than that in the amlodipine group ( P= 0.006). The risk of a doubling of the serum concentration was 33 percent lower in the irbesartan group than in the placebo group ( P= 0.003) and 37 percent lower in the irbesartan group than in the amlodipine group ( P