Renoprotective Effect of Dual Blockade of Renin-angiotensin System by the Combination of ACE inhibitor and ATII Receptor Antagonist in Type II Diabetic Nephropathy Patients with Overt Proteinuria

초록

Purpose: We evaluated the renoprotective effects of the dual blockade of rennin-angiotensin system (RAS) by the combination of ACE inhibiter (ACEi) and angiotensin II receptor blocker (ARB) as reflected by reduction of proteinuria and renal TGF-b production. Methods: A total of 21 patients with type II diabetes with 24-hour protein excretion rate more than 3.0 gm/day and previously having been received single dose of 5 mg of ramipril enrolled to double blinded prospective crossover study with 3 periods; (1) double dose (DD) of 10 mg ramipril, (2) the combination of 5mg ramipril and 8mg candesartan, and (3) DD of 16 mg of candesartan, each for 12 weeks.