Evidence-based Prevention and Treatment of Microalbuminuria in Patient with Type 2 Diabetes_Chinese Journal of Evidence-Based Medicine

Authors：

LI Zhipeng , LI Shuangqing

Sichuan International Hospital; West China Hospital; Sichuan University; Chengdu 610041; China;

Corresponding author：

Keywords：

Type 2 diabetes; Microalbuminuna; Angiotensin-convertin-genzyme inhibitors; Evidence-based prevention and treatment; Clinical evidence

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Objective 　To search evidence of angiotensin-converting-enzyme inhibitors for microalbumin-uria in type 2 diabetes for guiding clinical practice.
Methods 　We searched MEDLINE （ 1970 -Jun. 2005 ） to identify randomized controlled trials （RCT）of the effect on angiotensin-converting-enzyme inhibitors to prevent microalbuminuria in type 2 diabetes.
Results 　One RCT （n =1 204）was identified. The result showed that angiotensin-converting-enzyme inhibitors were significantly more effective in prevention of microalbuminuria than other medicines in type 2 diabetes. However, angiotensin-converting-enzyme inhibitors may increase the risk of cardiac mortality. We explained the evidence to patients and they were satisfied with our explanation.
Conclusions 　Angiotensin-converting-enzyme inhibitors can decrease the incidence of microalbuminuria in patients with type 2 diabetes and hypertension.

Citation： LI Zhipeng,LI Shuangqing. Evidence-based Prevention and Treatment of Microalbuminuria in Patient with Type 2 Diabetes. Chinese Journal of Evidence-Based Medicine, 2005, 05(8): 644-645. doi: Copy

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1. Ruggenenti P, Fassi A, Ilieva AP, Bruno S, Iliev IP, Brusegan V, Rubis N, Gherardi G, Arnoldi F, Ganeva M, Ene-Iordache B, Gaspari F, Perna A, Bossi A, Trevisan R, Dodesini AR, Remuzzi G; Bergamo Nephrologic Diabetes Complications Trial (BENEDICT) Investigators. Preventing microalbuminuria in type 2 diabetes[J]. N Engl J Med, 2004; 351(19): 1941-1951.
2. Ravid M, Brosh D, Levi Z, Bar-Dayan Y, Ravid D, Rachmani R. Use of enalapril to attenuate decline in renal function in normotensive, normoalbuminuric patients with type 2 diabetes mellitus. A randomized, controlled trial[J]. Ann Intern Med, 1998; 128(12 Pt 1): 982-988.
3. Murayama S, Hirano T, Sakaue T, Okada K, Ikejiri R, Adachi M. Low-dose candesartan cilexetil prevents early kidney damage in type 2 diabetic patients with mildly elevated blood pressure[J]. Hypertens Res, 2003; 26(6): 453-458.
4. Strojek K, Grzeszczak W, Gorska J, Leschinger MI, Ritz E. Lowering of microalbuminuria in diabetic patients by a sympathicoplegic agent: novel approach to prevent progression of diabetic nephropathy[J] ? J Am Soc Nephrol, 2001; 12(3): 602-605.
5. O’Hare P, Bilbous R, Mitchell T, O’Callaghan CJ, Viberti GC; Ace-Inhibitor Trial to Lower Albuminuria in Normotensive Insulin-Dependent Subjects Study Group. Low-dose ramipril reduces microalbuminuria in type 1 diabetic patients without hypertension: results of a randomized controlled trial[J]. Diabetes Care, 2000; 23(12): 1823-1829.
6. Shichiri M, Kishikawa H, Ohkubo Y, Wake N. Long-term results of the Kumamoto Study on optimal diabetes control in type 2 diabetic patients[J]. Diabetes Care, 2000; 23(Suppl 2): B21-29.
7. Arcaro G, Zenere BM, Saggiani F, et al. ACE inhibitors improve endothelial function in type 1 diabetic patients with normal arterial pressure and microalbuminuria[J]. Diabetes Care, 1999; 22(9): 1536-1542.

Chinese Journal of Evidence-Based Medicine

Evidence-based Prevention and Treatment of Microalbuminuria in Patient with Type 2 Diabetes

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