Clinical evaluation of the nephroprotection of blockers
DOI:
https://doi.org/10.51481/amc.v45i2.95Keywords:
Diabetes Mellitus tipo 2 , hipertensión arterial, inhibidores de la enzima convertidora de angioten-sina (IECAs) , antagonistas del receptor de angiotensina II (ARA II), nefropatía diabética, nefroprotecciónAbstract
The angiotensin receptor antagonists (ARA II) represent thelatest group of drugs in the treatment of hypertension and analternative against angiotensin-converting-enzyme (ACE) in-hibitors in patients with type 2 diabetes. Because its relevan-ce and polemic role, we reviewed several clinical trials to identify any renoprotective effect in patients with type 2 dia-betes with or without hypertension. We analized the resultsof REENAL,IDNT,IRMA II and MARVAL trials.
In conclusion,the renoprotective effect of the ARA II drugsis related especifically to changes in nephropathy morbilityand to a delay in the progression of nephropathy in diabeticpatients. We do not have data to generalize these properties toall the drugs of this group. Nevertheless,they might be indi-cated as an alternative to ACE inhibitors when side effects arepresent. It is not reasonable to expect the same renoprotecti-ve effect of ACE inhibitors because none of the ARA II drugshas diminished the mortality in patients with nephropathydue to type 2 diabetes and hypertension.
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