Angiotensin-converting enzyme diabetic nephropathy

Chymostatin-sensitive Il-generating enzyme Carvedilol Post-Infarct Survival Control in Left Ventricular Dysfunction Trial Collaborative Study Captopril Trial ( The Effect of Angiotensin-Converting Enzyme Inhibition on Diabetic Nephropathy ) calcium channel blocking agents Candesartan in Heart Failure Assessment of Reduction in Morbidity and Mortality Trial congestive heart failure, but the latest recommendations use HF for heart failure chronic kidney disease cardiac output... 

Lewis EJ, Elunsicker LG, Bain RP, Rohde RD. The effect of angiotensin converting enzyme on diabetic nephropathy. The Collaborative Study Group. N Engl JMed 1993 329 1456-62. 

ACE Inhibitors in Diabetic Nephropathy Trialist Group Should all patients with type 1 diabetes mellitus and microalbuminuria receive angiotensin-converting enzyme inhibitors A meta-analysis of individual patient data. Ann Intern Med 2001 134 370. 

Strippoli GFM, Craig M, Deeks)) et al. (2004) Effects of angiotensin converting enzyme inhibitors and angiotensin II receptor antagonists on mortality and renal outcomes in diabetic nephropathy systematic review. British Medical journal 329 1-12. 

Jacobsen P, Rossing K, Rossing P, et al. Angiotensin-converting enzyme gene polymorphism and ACE inhibition in diabetic nephropathy. Kidney Int 1998 53 1002-1006. 

Captopril, an angiotensin-converting enzyme inhibitor (ACE), is indicated in the management of hypertension by itself or in combination with other antihypertensive medications, in heart failure when the patients have not responded adequately to digitalis, after myocardial infarction associated with left ventricular dysfunction, and in diabetic nephropathy (Figure 25). 

Angiotensin-II-receptor antagonists (ARBs) are approved for the treatment of hypertension. In addition, irbesartan and losartan are approved for diabetic nephropathy, losar-tan is approved for stroke prophylaxis, and valsartan is approved for heart failure patients who are intolerant of angiotensin-converting enzyme (ACE) inhibitors. The efficacy of ARBs in lowering blood pressure (BP) is comparable with that of other established antihypertensive drugs, with an adverse-effect profile similar to that of placebo. ARBs also are available as fixed-dose combinations with hydrochlorothiazide. 

Angiotensin-converting enzyme inhibitor prototype used in HTN, diabetic nephropathy, and CHF. Tox hyperkalemia, fetal renal damage, cough ( sore throat ). Other prils benzepril, enalapril. lisinopril, quinapril. 

Fujisawa, T, Ikegami, H, Ono, M, Nishino, M, Noso, S, Kawabata, Y, Ogihara, T Combination of half doses of angiotensin type 1 receptor antagonist and angiotensin-converting enzyme inhibitor in diabetic nephropathy. Am. J. Hypertens. 18 13-17, 2005. 

Crook, E.D. and Penumalee, S. 2004. Therapeutic controversies in hypertension management angiotensin converting enzyme (ACE) inhibitors or angiotensin receptor blockers in diabetic nephropathy ACE inhibitors. Ethnicity disease, 14(4), S2-1-4. 

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