Long-term effect of lisinopril and atenolol on kidney function in hypertensive NIDDM subjects with diabetic nephropathy
Abstract
The aim of our study was to evaluate whether inhibition of ACE (lisinopril 10-20 mg/day) can reduce the rate of decline in kidney function more than reducing blood pressure with conventional antihypertensive treatment (atenolol 50-100 mg/day), usually in combination with a diuretic. We performed a prospective, randomized, parallel study for 42 months, double blind for the first 12 months and single blind thereafter. Forty-three (21 lisinopril and 22 atenolol) hypertensive NIDDM patients with diabetic nephropathy were enrolled. Data from 36 patients (17 lisinopril and 19 atenolol, 60 +/- 7 years of age, 27 men) who completed at least 12 months of the study period are presented. At baseline, the two groups were comparable: glomerular filtration rate (51Cr-EDTA plasma clearance) was 75 +/- 6 and 74 +/- 8 ml x min(-1) x 1.73 m(-2), mean 24-h ambulatory blood pressure (A&D TM2420) was 110 +/- 3 and 114 +/- 2 mmHg, and 24-h urinary albumin excretion rate was 961 (range 331-5,727) and 1,578 (476-5,806) mg/24 h in the lisinopril and atenolol groups, respectively. The mean follow-up time was similar, 37 and 35 months in the lisinopril and atenolol groups, respectively. Mean ambulatory blood pressure was equally reduced in the two groups, 12 +/- 2 and 10 +/- 2 mmHg in the lisinopril and atenolol groups, respectively. Glomerular filtration rate declined in a biphasic manner with a faster initial (0 to 6 months) change of 1.25 +/- 0.49 and 0.81 +/- 0.29 ml x min(-1) x month(-1) followed…
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Previous studies involving angiotensin-I-converting enzyme inhibitors demonstrated beneficial effects on proteinuria but did not demonstrate the superiority of renin-angiotensin system blockade in slowing progression to end-stage renal disease over nonblockade forms of therapy.
“Previous studies involving angiotensin-I-converting enzyme inhibitors have demonstrated beneficial effects on proteinuria but have not demonstrated the superiority of blockade of the renin-angiotensin system in slowing the progression to end-stage renal disease over nonblockade forms of therapy. 14-20”
From Effects of losartan on renal and cardiovascular outcomes in patients with type 2 diabetes and nephropathy (2001) · cites this paper as [17]
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Brenner, B. M., Cooper, M. E., de Zeeuw, D., Keane, W. F., Mitch, W. E., Parving, H.-H., Remuzzi, G., Snapinn, S. M., Zhang, Z., & Shahinfar, S. (2001) · New England Journal of Medicine · doi:10.1056/nejmoa011161 · Cited by 7,493 · see citing works
Self-citationRahman, M. (2005) · Archives of Internal Medicine · doi:10.1001/archinte.165.8.936 · Cited by 340 · see citing works
Evidence-based practice guideline for the treatment for diabetes in Japan 2013
Tajima, N., Noda, M., Origasa, H., Noto, H., Yabe, D., Fujita, Y., Goto, A., Fujimoto, K., Sakamoto, M., & Haneda, M. (2015) · Diabetology International · doi:10.1007/s13340-015-0206-2 · Cited by 154 · see citing works
- Authors
- Nielsen, F. S., Rossing, P., Gall, M. A., Skott, P., Smidt, U. M., & Parving, H. H.
- Venue
- Diabetes
- Publisher
- American Diabetes Association
- Published
- 1997-07-01
- Volume
- 46
- Issue
- 7
- Pages
- 1182-1188
- ISSN
- 0012-1797 (ISSN-L)
- OpenAlex
- W1966972471
- Cited by
- 182
- References
- 0
- Citations by year
- 2026: 1 · 2023: 2 · 2021: 1 · 2020: 2 · 2018: 2 · 2016: 3 · 2015: 2 · 2014: 1 · 2013: 4 · 2012: 4
- FWCI
- 13.30
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Diabetes (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Ipsen
- Topics
- Health Sciences › Medicine › Nephrology › Chronic Kidney Disease and Diabetes
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Blood Pressure and Hypertension Studies
- Health Sciences › Medicine › Nephrology › Renal Diseases and Glomerulopathies
- Keywords
- lisinopril, atenolol, diabetic nephropathy, type 2 diabetes, hypertension, ACE inhibitors, beta-blockers, glomerular filtration rate decline, albuminuria, ambulatory blood pressure, antihypertensive therapy, renal function preservation, long-term follow-up, diuretics, 51Cr-EDTA clearance, urinary albumin
- MeSH terms
- Aged, Albuminuria, Angiotensin-Converting Enzyme Inhibitors, Animals, Antihypertensive Agents, Atenolol, Blood Pressure, Diabetes Mellitus, Type 2, Diabetic Nephropathies, Double-Blind Method, Follow-Up Studies, Glomerular Filtration Rate, Humans, Hypertension, Renal, Kidney, Male, Middle Aged, Prospective Studies, Rabbits, Time Factors, Single-Blind Method, Lisinopril
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