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15 April 1993 | Volume 118 Issue 8 | Pages 577-581
Objective: To evaluate the long-term effect of angiotensin-converting enzyme inhibition on proteinuria and on the rate of decline in kidney function in patients with type II diabetes mellitus and microalbuminuria.
Design: Randomized, double-blind, placebo-controlled trial. Each patient was followed for 5 years.
Setting: Six clinics for diabetes mellitus coordinated by a department of medicine in a university hospital in Israel.
Patients: Ninety-four normotensive, type II diabetic patients with microalbuminuria and normal renal function.
Intervention: The patients were randomly assigned to receive enalapril, 10 mg per day, or placebo. Any increase in blood pressure was treated with long-acting nifedipine.
Measurements: Albuminuria, blood pressure, serum creatinine, fasting blood glucose, and glycosylated hemoglobin levels, every 3 to 4 months.
Results: In the patients treated with enalapril, albuminuria decreased from 143 ± 64 (mean ±SD) mg/24 h to 122 ± 67 mg/24 h during the first year. Thereafter, we observed a slow increase to 140 ± 134 mg/24 h after 5 years. In the placebo group, albuminuria increased from 123 ± 58 mg/24 h to 310 ± 167 mg/24 h after 5 years. (Difference in rate of change in proteinuria [P < 0.05]). Kidney function (expressed as mean reciprocal creatinine) declined by 13% in the placebo group and remained stable (- 1%) in the enalapril group (P < 0.05). Control of blood glucose levels remained stable, in both groups, throughout the study. The mean blood pressure was stable in the enalapril group (initial group mean, 99 ± 2.1 mm Hg; fifth-year mean, 100 ± 3.2 mm Hg) and increased in the placebo group from an initial mean value of 97 ± 3.2 mm Hg to 102 ± 3.4 mm Hg at the end of the study period (P = 0.082).
Conclusions: In normotensive patients with diabetes mellitus type II, the institution of angiotensin-converting enzyme inhibition during early stages of diabetic nephropathy results in long-term stabilization of plasma creatinine levels and of the degree of urinary loss of albumin. These effects are probably independent of the antihypertensive action of these agents.
Available data suggest that effective antihypertensive treatment is the best inhibitor of diabetic nephropathy [7-10]. Angiotensin-converting enzyme inhibitors have been found more effective than placebo and ß-adrenergic blocking agents in hypertensive as well as in normotensive diabetics with early and advanced nephropathy [11-15]. Some classes of calcium antagonists effectively decrease urinary protein excretion and may preserve renal function. However, analysis of several studies shows that, although the effects of angiotensin-converting enzyme inhibitors are consistent, those of calcium antagonists vary [16-18].
Short-term studies showed a clear antiproteinuric effect of captopril and of enalapril on the diabetic kidney, probably independent of the antihypertensive effect of these agents [14, 15, 19]. However, the outcome of long-term intervention and the possibility of a true alteration of the natural course of the disease were unknown. We did a relatively long-term, 5-year study of the effect of the angiotensin-converting enzyme inhibitor, enalapril, on the course of diabetic nephropathy in normotensive, type II diabetic patients with microalbuminuria and normal renal function. Our report describes a randomized, placebo-controlled, double-blind study on 94 diabetic patients.
A total of 108 patients with type II diabetes mellitus, diagnosed according to World Health Organization criteria [20] who attended six clinics in the Tel Aviv area were recruited during 1986 and gave informed consent to participate in the study.
The inclusion criteria were as follows: age less than 50 years; duration of diabetes mellitus of less than 10 years with no evidence of systemic, renal, cardiac, or hepatic diseases; body mass index less than 27 kg/m2; normal blood pressure values on two consecutive examinations (systolic,
Initially, there were 49 men and 59 women, ages 34 to 49 years (mean age [±SD], 44 ± 4 years). The duration of diabetes was 0.5 to 9.1 years (mean duration [±SD], 6.7 ± 1.6 years). Sixteen patients received insulin, 43 were taking oral hypoglycemic agents, and 49 were using diet to control their diabetes.
Protocol
The protocol was approved by the hospital review board. After a 2-month pretreatment period, the patients were randomly allocated to receive either 10 mg enalapril (Teva Pharmaceutical Industries, Ltd., Petach Tikwa, Israel) daily or placebo in a double-blind manner. The placebo tablets were similar but not identical to enalapril. Randomization was done using a table of random numbers [21]. The follow-up period was terminated, for each patient, exactly 5 years after his or her randomization, and the data were submitted for evaluation.
The patients were seen by their family physicians approximately every 3 to 4 months. On these visits, fasting blood glucose, glycosylated hemoglobin, serum creatinine, serum electrolyte levels, and albuminuria in 24-hour urine samples were determined. Blood pressure was measured by mercury sphygmomanometers with the patients sitting after a 5-minute rest; the average of two determinations was recorded. The diastolic pressure was determined at Korotkoff phase V. If systolic blood pressure values of
Measurements
Glucose and creatinine levels were determined by routine automated methods. Glycosylated hemoglobin levels were measured by affinity chromatography with a commercial kit (Isolab, Biochemical Methodology, Drower 4350, Akron, Ohio). The albumin excretion rate was measured on 24-hour urine samples by an automated immunoturbidimetric assay [22].
Sixteen to 20 fasting blood glucose determinations and 15 to 20 glycosylated hemoglobin values were available for each patient. For each patient, the correlation coefficients between fasting blood glucose and glycosylated hemoglobin levels were between 0.60 and 0.84. The mean blood pressure values were calculated for each patient (mean pressure defined as diastolic value plus one third of the pulse pressure). The reciprocal creatinine value (100/creatinine value) was calculated for each visit [23], and the decline in renal function was expressed as a percentage of the initial value. The course of renal function, of the mean blood pressure, and of urinary protein excretion were plotted against time (separately) for the enalapril and the placebo groups.
Statistical Analysis
All data were expressed as mean (±SD) and ranges. Significance was defined as P < 0.05. To test for adequate randomization, the enalapril and placebo groups were compared with respect to mean age, mean duration of diabetes, as well as mean baseline values of albuminuria, serum creatinine, glycosylated hemoglobin, and mean blood pressure using pooled variance Student t-tests for independent groups as well as one-way analysis of variance. To compare the annual means of the various measurements between the two groups and within each group, one between-group factor and one repeated measures factor were used in analysis of variance. The rate of decrease of reciprocal creatinine levels and the rate of increase of albuminuria were calculated by linear regression analysis. ARTICLE
Long-Term Stabilizing Effect of Angiotensin-Converting Enzyme Inhibition on Plasma Creatinine and on Proteinuria in Normotensive Type II Diabetic Patients
Diabetic nephropathy is the single most important cause of end-stage renal failure in the western world. It accounts for 15% to 25% of all renal failure in patients receiving chronic dialysis [1]. About 40% of type I and 20% of type II diabetics develop clinically important nephropathy [2-4]. However, the ratio of type II to type I diabetics is 10 to 1, and the number of patients with chronic renal failure due to type II disease exceeds that of type I [4-6]. Therefore, an obvious need exists to evaluate treatments that may delay the progress of nephropathy in type II diabetes. However, most studies of diabetic renal disease have hitherto focused on type I diabetes.
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Patients
140 mm Hg; diastolic, 90 mm Hg; mean blood pressure < 107 mm Hg); serum creatinine, < 123 µmol/L (1.4 mg/dL); and microalbuminuria (urinary protein excretion of 30 to 300 mg/24 h) on two consecutive visits without evidence of urinary tract infection. 
145 mm Hg, or diastolic values of 95 mm Hg, were found on two consecutive occasions, treatment with long-acting nifedipine (Pressolate, Agis Industries Ltd., Yeruham, Israel) was initiated. Funduscopy was done yearly by an ophthalmologist, and the presence of diabetic retinopathy was recorded.
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Five patients, 2 taking enalapril and 3 taking placebo left the study during the first year. Six patients (4 taking enalapril and 2 taking placebo) developed a disturbing cough, and the treatment was discontinued. Three patients (1 on enalapril and 2 on placebo) were lost to follow-up during the third and fourth years. The final analysis was therefore done on 94 patients, of whom 49 received enalapril and 45 received placebo. Age, male/female ratio, duration of diabetes, and the other baseline data of the two groups are shown in Table 1. No statistically significant differences existed between the initial characteristics of the enalapril and the placebo groups.
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During the first year of treatment, the urinary albumin excretion in the enalapril group decreased from an initial mean of 143 mg/24 h to an annual mean of 122 mg/24 h. Values greater than 300 mg/24 h were recorded in only two patients. Subsequently, a minimal but steady increase occurred in mean daily albumin excretion of these patients, with a fourth-year mean of 136 mg/24 h and a fifth-year mean of 140 mg/24 h. In six patients, albuminuria exceeded 300 mg/24 h. In contrast, among the placebo-treated patients, a steady, gradual increase occurred in mean daily albuminuria. The initial albumin value was 123 mg/24 h, the first-year mean was 134 mg/24 h, and the fifth-year value was 310 mg/24 h. Albumin values were greater than 300 mg/24 h in 19 patients and greater than 1 mg/24 h in three patients. The difference between the mean values of daily albuminuria in the two groups became statistically significant after the first year. However, the difference in the rate of change in proteinuria from baseline was statistically significant at the end of the first year (P < 0.05). These data are shown in Figure 1 and are numerically detailed in the Appendix Table. If the development of overt proteinuria ( 300 mg/24 h) is considered clinically important, the risk for developing this degree of proteinuria within 5 years of follow-up was 19/45 (42%) in the placebo group compared with 6/49 (12%) in the enalapril group. Therefore, enalapril treatment resulted in an absolute risk reduction of 30 percentage points for the development of overt proteinuria (95% CI, 15% to 45%; P < 0.001) for a 5-year period.
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Renal function, expressed as reciprocal creatinine (100/cr) remained unchanged in the enalapril group during the first 2 years of follow-up. From the third year onward, a small, nonsignificant but systematic decrease was recorded. The decrease was 1% of the initial value during the 5 years. In the placebo-treated group, a gradual, steady decrease of about 2% occurred in renal function each year. The difference between the initial and mean fifth-year values was 13% (P < 0.05). The difference between the mean rate of decrease of reciprocal creatinine among the enalapril- and the placebo-treated groups became significant after the second year. These data are shown in Figure 2 and are outlined in the Appendix Table.
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The mean blood pressure in the enalapril-treated patients decreased slightly from an initial value of 99 mm Hg to 96 mm Hg during the first year. Thereafter, a gradual and nonsignificant increase was recorded; the final mean value was 100 mm Hg for the fifth year. In three patients in this group, systolic blood pressure values greater than 145 mm Hg or diastolic values greater than 95 mm Hg were recorded, and treatment with a long-acting nifedipine preparation (Pressolate), 10 to 20 mg twice daily, was added. In the placebo-treated group, the annual mean blood pressure increase was 1 to 3 mm Hg. In nine patients (2 each in the second to fourth years and 3 in the fifth year), elevated blood pressure levels were found and were treated by using long-acting nifedipine. The mean blood pressure values are shown in Figure 3.
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Changes compatible with diabetic retinopathy were found during the 5-year period in 9 patients (18%) who received enalapril and in 13 patients (29%) receiving placebo (P < 0.002). Two patients in each group had proliferative changes. The body mass index increased slightly in both groups of patients. The control of glucose levels was stable as judged by the steady, mean fasting blood sugar and glycosylated hemoglobin values during the 5 years. The serum potassium values were higher in the patients who received enalapril; the mean values during the fifth year were 4.26 ± 0.31 mmol/L for enalapril compared with 3.98 ± 0.36 mmol/L for placebo (P < 0.05).
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Renal protection by angiotensin-converting enzyme inhibitors (albumin excretion and preservation of renal function) was described in hypertensive and in normotensive patients with diabetic nephropathy [7-15] and also in nondiabetic patients with proteinuria [24, 25]. However, most of the studies were short term, comprised small numbers of patients, and were mainly concerned with type I diabetes. Whether the beneficial effect of angiotensin-converting enzyme inhibitors would persist during a longer period was unknown.
In the present study, the decrease in proteinuria from an initial mean of 143 mg/24 h to a first-year average of 122 mg/24 h was followed by a slow increase toward a fifth-year average of 140 mg/24 h. Among the 49 patients treated with enalapril, only 6 patients had proteinuria that increased beyond the 300 mg/24 h threshold. In contrast, the mean daily albumin excretion of the patients who received placebo increased progressively from year to year. The fifth-year average was 152% greater than the initial value (P < 0.001), with 19 patients who had 24-hour albumin excretion values greater than 300 mg. These differences could not be attributed to differences in glycemic control, body mass index, or blood pressure values, which were very similar in both groups throughout the study period.
We monitored renal function using a crude method that is not as accurate as the method of measuring glomerular filtration rate used by others. Therefore, our conclusions about renal function must be expressed with appropriate caution. Nevertheless, for a group of patients who maintained a steady body mass index as well as an adequate and stable control of glucose metabolism, a steady trend in the plasma creatinine level is probably a reliable index of renal function [23, 26, 27].
Early stages of diabetes mellitus are characterized by increases in intracapillary pressure regardless of systemic arterial blood pressure [28]. Evidence, both in humans and in experimental animals, suggests that the effect of angiotensin-converting enzyme inhibitors in the kidney is to decrease efferent arteriolar resistance with resulting reduction of intraglomerular capillary hydraulic pressure [29-31]. In addition, a gradual decrease of glomerular membrane permeability to protein takes place. The dependence of these changes on the intraglomerular pressure is not clear. In certain animal models [32], the development of glomerulosclerosis was attenuated regardless of changes in intraglomerular pressure. Other studies [33] indicate that intraglomerular pressure is the main factor in preserving renal function.
Our present study corroborates previous evidence about the antiproteinuric effect and the renal protective effect of angiotensin-converting enzyme inhibition in early diabetic nephropathy in normotensive patients with type II diabetes. This effect is long-lasting and possibly additional to as well as independent of the antihypertensive effect of these agents. Thus, long-term administration of angiotensin-converting enzyme inhibitors should be considered seriously in both type I and type II diabetic patients with microalbuminuria, regardless of their blood pressure. We also need controlled, long-term clinical trials with these agents in diabetic patients without proteinuria to find a method for delaying the development of diabetic nephropathy.
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1. Eggers PW, Connerton R, McMullan M. The Medicare experience with end-stage renal disease: trends in incidence, prevalence, and survival. Health Care Financ Rev. 1984; 5:69-88.
2. Andersen AR, Christiansen JS, Andersen JK, Kreiner S, Deckert T. Diabetic nephropathy in type I (insulin-dependent) diabetes: an epidemiological study. Diabetologia. 1983; 25:496-501.
3. Parving HH, Smidt UM, Friisberg B, Bonnevie-Nielsen V, Andersen AR. A prospective study of glomerular filtration rate and arterial blood pressure in insulin-dependent diabetics with diabetic nephropathy. Diabetologia. 1981; 20:457-61.
4. Klein R, Klien BE, Moss S, DeMets DL. Proteinuria in diabetes. Arch Intern Med. 1988; 148:181-6.
5. Rettig B, Teutsch SM. The incidence of end stage renal disease in type I and type II diabetes mellitus. Diabetic Nephropathy. 1984; 3:26-7.
6. Nelson RG, Newman JM, Knowler WC, Sievers ML, Kunzelman CL, Pettitt DJ, et al. Incidence of end-stage renal disease in type 2 (non-insulin-dependent) diabetes mellitus in Pima Indians. Diabetologia. 1988; 31:730-6.
7. Mogensen CE. Long-term antihypertensive treatment inhibiting progression of diabetic nephropathy. Br Med J. 1982; 285:685-8.
8. Parving HH, Andersen AR, Smidt UM, Svendsen PA. Early aggressive antihypertensive treatment reduces rate of decline in kidney function in diabetic nephropathy. Lancet. 1983; 1:1175-8.
9. Parving HH, Andersen AR, Smidt UM, Hommel E, Mathiesen ER, Svendsen PA. Effect of antihypertensive treatment on kidney function in diabetic nephropathy. Br Med J. 1987; 294:1443-7.
10. Ravid M, Savin H, Lang R, Jutrin I, Ludvinovsky S, Lishner M. Proteinuria, renal impairment, metabolic control, and blood pressure in type 2 diabetes mellitus. A 14-year follow-up report on 195 patients. Arch Intern Med. 1992; 152:1225-9.
11. Parving HH, Hommel E, Smidt UM. Protection of kidney function and decrease in albuminuria by captopril in insulin dependent diabetics with nephropathy. BMJ. 1988; 297:1086-91.
12. Bjorck S, Mulec H, Johnsen SA, Norden G, Aurell M. Renal protective effect of enalapril in diabetic nephropathy. BMJ. 1992; 304: 339-43.
13. Ueda Y, Aoi W, Yamachika Sh, Shikaya T. Beneficial effects of angiotensin-converting enzyme inhibitor on renal function and glucose homeostasis in diabetics with hypertension. Nephron. 1990; 55(Suppl 1):85-9.
14. Mathiesen ER, Hommel E, Giese J, Parving HH. Eficacy of captopril in postponing nephropathy in normotensive insulin dependent diabetic patients with microalbuminuria. BMJ. 1991; 303:81-7.
15. Marre M, Chatellier G, Leblanc H, Guyene TT, Menard J, Passa P. Prevention of diabetic nephropathy with enalapril in normotensive diabetics with microalbuminuria. BMJ. 1988; 297:1092-5.
16. Gansevoort RT, Aperloo AJ, Heeg JE, de Jong PE, de Zeeuw D. The antiproteinuric effect of antihypertensive agents in diabetic nephropathy (Letter). Arch Intern Med. 1992; 152:2137-9.
17. Bakris GL, Barnhill BW, Sadler R. Treatment of arterial hypertension in diabetic humans: importance of therapeutic selection. Kidney Int. 1992; 41:912-9.
18. Bianchi S, Bigazzi R, Baldari G, Campese VM. Long-term effects of enalapril and nicardipine on urinary albumin excretion in patients with chronic renal insufficiency: a 1-year follow up. Am J Nephrol. 1991; 11:131-7.
19. Valentino VA, Wilson MD, Weart W, Bakris GL. A perspective on converting enzyme inhibitors and calcium channel antagonists in diabetic renal disease. Arch Intern Med. 1991; 151:2367-72.
20. WHO expert committee on Diabetes Mellitus: second report. Geneva, WHO 1980 (Tech Rep. Ser No 646).
21. Shott S. Statistics for health professionals. Philadelphia: WB Saunders; 1990; 57-60.
22. Sathianathan P, Rege VP, Barron JL. Immunoturbidimetric determination of urinary albumin with a centrifugal analyzer. Clin Chem. 1986; 32:202.
23. Rutherford WE, Blondin J, Miller JP, Greenwalt AS, Varva JD. Chronic progressive renal disease: rate of change of serum creatinine concentration. Kidney Int. 1977; 11:62-70.
24. Ferder LF, Inserra F, Daccordi H, Smith RD. Enalapril improved renal function and proteinuria in chronic glomerulopathies. Nephron. 1990; 55(Suppl 1):90-5.
25. Apperloo AJ, de Zeeuw D, Sluiter HE, de Jong PE. Differential effects of enalapril and atenolol on proteinuria and renal hemodynamics in non-diabetic renal disease. BMJ. 1991; 303:821-4.
26. Cockcroft DW, Gault MH. Prediction of creatinine clearance from serum creatinine. Nephron. 1976; 16:31-41.
27. Mitch WE, Walser M. The effect of nutritional therapy on progression of chronic renal failure: quantitative assessment (Abstract). Clin Res. 1976; 24:407.
28. Sandeman DD, Shore AC, Tooke JE. Relation of skin capillary pressure in patients with insulin-dependent diabetes mellitus to complications and metabolic control. N Engl J Med. 1992; 327:760-4.
29. Parving HH, Viberti GC, Keen H, Christiansen JS, Lassen NA. Hemodynamic factors in the genesis of diabetic microangiopathy. Metabolism. 1983; 32:943-9.
30. Andersen S, Rennke HG, Brenner BM. Therapeutic advantage of converting enzyme inhibitors in arresting progressive renal disease associated with systemic hypertension in the rat. J Clin Invest. 1986; 77:1993-2000.
31. Zatz R, Dunn BR, Meyer TW, Anderson S, Rennke HG, Brenner B. Prevention of diabetic glomerulopathy by pharmacological amelioration of glomerular capillary hypertension. J Clin Invest. 1986; 77: 1925-30.
32. Fugo A, Yoshida Y, Glick AD, Homma T, Ichikawa I. Serial micropuncture analysis of glomerular function in two rat models of glomerular sclerosis. J Clin Invest. 1988; 82:322-30.
33. Weidmann P, Beretta-Piccoli C, Trost BN. Pressor factors and responsiveness in hypertension accompanying diabetes mellitus. Hypertension. 1985; 7(Suppl 2):33-42.
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A. A.M. Zandbergen, M. G.A. Baggen, S. W.J. Lamberts, A. H. Bootsma, D. de Zeeuw, and R. J.Th. Ouwendijk Effect of Losartan on Microalbuminuria in Normotensive Patients with Type 2 Diabetes Mellitus: A Randomized Clinical Trial Ann Intern Med, July 15, 2003; 139(2): 90 - 96. [Abstract] [Full Text] [PDF]
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A. Benigni, C. Zoja, D. Corna, C. Zatelli, S. Conti, M. Campana, E. Gagliardini, D. Rottoli, C. Zanchi, M. Abbate, et al. Add-On Anti-TGF-{beta} Antibody to ACE Inhibitor Arrests Progressive Diabetic Nephropathy in the Rat J. Am. Soc. Nephrol., July 1, 2003; 14(7): 1816 - 1824. [Abstract] [Full Text] [PDF]
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 H. J. Kramer, Q. D. Nguyen, G. Curhan, and C.-y. Hsu Renal Insufficiency in the Absence of Albuminuria and Retinopathy Among Adults With Type 2 Diabetes Mellitus JAMA, June 25, 2003; 289(24): 3273 - 3277. [Abstract] [Full Text] [PDF]
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 C. Stigant, L. Stevens, and A. Levin Nephrology: 4. Strategies for the care of adults with chronic kidney disease Can. Med. Assoc. J., June 10, 2003; 168(12): 1553 - 1560. [Full Text] [PDF]
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M. B. Davidson The Case for "Outsourcing" Diabetes Care Diabetes Care, May 1, 2003; 26(5): 1608 - 1612. [Full Text] [PDF]
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S. Vijan and R. A. Hayward Treatment of Hypertension in Type 2 Diabetes Mellitus: Blood Pressure Goals, Choice of Agents, and Setting Priorities in Diabetes Care Ann Intern Med, April 1, 2003; 138(7): 593 - 602. [Abstract] [Full Text] [PDF]
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P. Gaede, H. P. Hansen, H.-H. Parving, and O. Pedersen Impact of low-dose acetylsalicylic acid on kidney function in type 2 diabetic patients with elevated urinary albumin excretion rate Nephrol. Dial. Transplant., March 1, 2003; 18(3): 539 - 542. [Abstract] [Full Text] [PDF]
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A. D. Mooradian Cardiovascular Disease in Type 2 Diabetes Mellitus: Current Management Guidelines Arch Intern Med, January 13, 2003; 163(1): 33 - 40. [Abstract] [Full Text] [PDF]
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 The DIRECT Programme Study Group and N. Chaturvedi The DIabetic Retinopathy Candesartan Trials (DIRECT) Programme, rationale and study design Journal of Renin-Angiotensin-Aldosterone System, December 1, 2002; 3(4): 255 - 261. [Abstract] [PDF]
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F. C. Sasso, O. Carbonara, M. Persico, D. Iafusco, T. Salvatore, R. D'Ambrosio, R. Torella, and D. Cozzolino Irbesartan Reduces the Albumin Excretion Rate in Microalbuminuric Type 2 Diabetic Patients Independently of Hypertension: A randomized double-blind placebo-controlled crossover study Diabetes Care, November 1, 2002; 25(11): 1909 - 1913. [Abstract] [Full Text] [PDF]
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G. Deferrari, M. Ravera, L. Deferrari, S. Vettoretti, E. Ratto, and D. Parodi Renal and Cardiovascular Protection in Type 2 Diabetes Mellitus: Angiotensin II Receptor Blockers J. Am. Soc. Nephrol., November 1, 2002; 13(90003): S224 - 229. [Abstract] [Full Text]
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S. W. Tobe, P. A. McFarlane, and D. M. Naimark Microalbuminuria in diabetes mellitus Can. Med. Assoc. J., September 1, 2002; 167(5): 499 - 503. [Full Text]
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Z. T. Bloomgarden Treatment of Type 2 Diabetes: The American Association of Clinical Endocrinologists Meeting, May 2002 Diabetes Care, September 1, 2002; 25(9): 1644 - 1649. [Full Text] [PDF]
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G. Viberti, N. M. Wheeldon, and for the MicroAlbuminuria Reduction With VALsartan Microalbuminuria Reduction With Valsartan in Patients With Type 2 Diabetes Mellitus: A Blood Pressure-Independent Effect Circulation, August 6, 2002; 106(6): 672 - 678. [Abstract] [Full Text] [PDF]
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P. Swales and B. Williams Review: Calcium channel blockade in combination with angiotensin-converting enzyme inhibition or angiotensin II (AT1-receptor) antagonism in hypertensive diabetics and patients with renal disease and hypertension Journal of Renin-Angiotensin-Aldosterone System, June 1, 2002; 3(2): 79 - 89. [Abstract] [PDF]
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H. Gallagher and P. A Andrews What is diabetic renal disease? The British Journal of Diabetes & Vascular Disease, March 1, 2002; 2(2): 96 - 100. [Abstract] [PDF]
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 |
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 J. P Garg and G. L Bakris Microalbuminuria: marker of vascular dysfunction, risk factor for cardiovascular disease Vascular Medicine, February 1, 2002; 7(1): 35 - 43. [Abstract] [PDF]
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|
 |
|
 M. A J Devonald and F. E Karet Targeting the renin-angiotensin system in patients with renal disease J R Soc Med, January 8, 2002; 95(8): 391 - 397. [Full Text] [PDF]
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A. M.E. Spoelstra-de Man, C. B. Brouwer, C. D.A. Stehouwer, and Y. M. Smulders Rapid Progression of Albumin Excretion Is an Independent Predictor of Cardiovascular Mortality in Patients With Type 2 Diabetes and Microalbuminuria Diabetes Care, December 1, 2001; 24(12): 2097 - 2101. [Abstract] [Full Text] [PDF]
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E. J. Lewis, L. G. Hunsicker, W. R. Clarke, T. Berl, M. A. Pohl, J. B. Lewis, E. Ritz, R. C. Atkins, R. Rohde, I. Raz, et al. Renoprotective Effect of the Angiotensin-Receptor Antagonist Irbesartan in Patients with Nephropathy Due to Type 2 Diabetes N. Engl. J. Med., September 20, 2001; 345(12): 851 - 860. [Abstract] [Full Text] [PDF]
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B. M. Brenner, M. E. Cooper, D. de Zeeuw, W. F. Keane, W. E. Mitch, H.-H. Parving, G. Remuzzi, S. M. Snapinn, Z. Zhang, S. Shahinfar, et al. Effects of Losartan on Renal and Cardiovascular Outcomes in Patients with Type 2 Diabetes and Nephropathy N. Engl. J. Med., September 20, 2001; 345(12): 861 - 869. [Abstract] [Full Text] [PDF]
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H.-H. Parving, H. Lehnert, J. Brochner-Mortensen, R. Gomis, S. Andersen, P. Arner, and the Irbesartan in Patients with Type 2 Diabetes an The Effect of Irbesartan on the Development of Diabetic Nephropathy in Patients with Type 2 Diabetes N. Engl. J. Med., September 20, 2001; 345(12): 870 - 878. [Abstract] [Full Text] [PDF]
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P. Huston and R. Peterson Withholding Proven Treatment in Clinical Research N. Engl. J. Med., September 20, 2001; 345(12): 912 - 914. [Full Text] [PDF]
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P. A Swift and G. A MacGregor Renoprotection in Type 2 diabetes: blockade of the renin-angiotensin system with angiotensin II receptor blockers Journal of Renin-Angiotensin-Aldosterone System, September 1, 2001; 2(3): 170 - 173. [PDF]
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M. P. Cohen, C. W. Shearman, and G. T. Lautenslager Serum Type IV Collagen in Diabetic Patients at Risk for Nephropathy Diabetes Care, August 1, 2001; 24(8): 1324 - 1327. [Abstract] [Full Text] [PDF]
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M. P. Cohen, G. T. Lautenslager, and C. W. Shearman Increased Collagen IV Excretion in Diabetes: A marker of compromised filtration function Diabetes Care, May 1, 2001; 24(5): 914 - 918. [Abstract] [Full Text]
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W. THOMAS, Y. SHEN, M. E. MOLITCH, and M. W. STEFFES Rise in Albuminuria and Blood Pressure in Patients Who Progressed to Diabetic Nephropathy in the Diabetes Control and Complications Trial J. Am. Soc. Nephrol., February 1, 2001; 12(2): 333 - 340. [Abstract] [Full Text]
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M. W. Taal, G. M. Chertow, H. G. Rennke, A. Gurnani, T. Jiang, A. Shahsafaei, J. L. Troy, B. M. Brenner, and H. S. Mackenzie Mechanisms underlying renoprotection during renin-angiotensin system blockade Am J Physiol Renal Physiol, February 1, 2001; 280(2): F343 - F355. [Abstract] [Full Text] [PDF]
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Z. J. Cheng, T. Vaskonen, I. Tikkanen, K. Nurminen, H. Ruskoaho, H. Vapaatalo, D. Muller, J.-K. Park, F. C. Luft, and E. M. A. Mervaala Endothelial Dysfunction and Salt-Sensitive Hypertension in Spontaneously Diabetic Goto-Kakizaki Rats Hypertension, February 1, 2001; 37(2): 433 - 439. [Abstract] [Full Text] [PDF]
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B. M Brenner, M. E Cooper, D. de Zeeuw, J.-P. Grunfeld, W. F Keane, K. Kurokawa, J. B McGill, W. E Mitch, H. H. Parving, G. Remuzzi, et al. The losartan renal protection study -- rationale, study design and baseline characteristics of RENAAL (Reduction of Endpoints in NIDDM with the Angiotensin II Antagonist Losartan) Journal of Renin-Angiotensin-Aldosterone System, December 1, 2000; 1(4): 328 - 335. [Abstract] [PDF]
|
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|
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|
 A.O. Phillips Diabetic nephropathy--where next? QJM, October 1, 2000; 93(10): 643 - 646. [Full Text] [PDF]
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|
|
E. Grossman, F. H. Messerli, and J. M. Neutel Angiotensin II Receptor Blockers: Equal or Preferred Substitutes for ACE Inhibitors? Arch Intern Med, July 10, 2000; 160(13): 1905 - 1911. [Full Text] [PDF]
|
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|
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|
 M. B. Davidson, V. J. Karlan, and T. L. Hair Effect of a Pharmacist-Managed Diabetes Care Program in a Free Medical Clinic American Journal of Medical Quality, July 1, 2000; 15(4): 137 - 142. [Abstract] [PDF]
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R. H. Mehta, T. J. Ruane, P. A. McCargar, K. A. Eagle, and E. J. Stalhandske The Treatment of Elderly Diabetic Patients With Acute Myocardial Infarction: Insight From Michigan's Cooperative Cardiovascular Project Arch Intern Med, May 8, 2000; 160(9): 1301 - 1306. [Abstract] [Full Text] [PDF]
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|
 J. R. Petrie, A. D. Morris, S. Ueda, M. Small, R. Donnelly, J. M. C. Connell, and H. L. Elliott Trandolapril Does Not Improve Insulin Sensitivity in Patients with Hypertension and Type 2 Diabetes: A Double-Blind, Placebo-Controlled Crossover Trial J. Clin. Endocrinol. Metab., May 1, 2000; 85(5): 1882 - 1889. [Abstract] [Full Text]
|
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|
|
|
R. A. Rodby, R. D. Rohde, W. R. Clarke, L. G. Hunsicker, D. A. Anzalone, R. C. Atkins, E. Ritz, and E. J. Lewis The Irbesartan Type II Diabetic Nephropathy Trial: study design and baseline patient characteristics Nephrol. Dial. Transplant., April 1, 2000; 15(4): 487 - 497. [Abstract] [Full Text] [PDF]
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|
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J. SOMA, T. SAITO, Y. TAGUMA, S. CHIBA, H. SATO, K. SUGIMURA, S. OGAWA, and S. ITO High Prevalence and Adverse Effect of Hepatitis C Virus Infection in Type II Diabetic-Related Nephropathy J. Am. Soc. Nephrol., April 1, 2000; 11(4): 690 - 699. [Abstract] [Full Text] [PDF]
|
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|
|
|
W. F. Clark, D. N. Churchill, L. Forwell, G. Macdonald, and S. Foster To pay or not to pay? A decision and cost-utility analysis of angiotensin-converting-enzyme inhibitor therapy for diabetic nephropathy Can. Med. Assoc. J., January 1, 2000; 162(2): 195 - 198. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
R. D. Feldman, N. Campbell, P. Larochelle, P. Bolli, E. D. Burgess, S. G. Carruthers, J. S. Floras, R. B. Haynes, G. Honos, F. H.H. Leenen, et al. 1999 Canadian recommendations for the management of hypertension Can. Med. Assoc. J., December 14, 1999; 161(90120): S1 - 17. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
L. Golan, J. D. Birkmeyer, and H. G. Welch The Cost-Effectiveness of Treating All Patients with Type 2 Diabetes with Angiotensin-Converting Enzyme Inhibitors Ann Intern Med, November 2, 1999; 131(9): 660 - 667. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
E. Ritz and S. R. Orth Nephropathy in Patients with Type 2 Diabetes Mellitus N. Engl. J. Med., October 7, 1999; 341(15): 1127 - 1133. [Full Text] [PDF]
|
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|
|
|
S. M. Grundy, I. J. Benjamin, G. L. Burke, A. Chait, R. H. Eckel, B. V. Howard, W. Mitch, S. C. Smith Jr, and J. R. Sowers Diabetes and Cardiovascular Disease : A Statement for Healthcare Professionals From the American Heart Association Circulation, September 7, 1999; 100(10): 1134 - 1146. [Full Text] [PDF]
|
|
|
|
 |
|
 S. P. Marso, S. G. Ellis, E. M. Tuzcu, P. L. Whitlow, I. Franco, R. E. Raymond, and E. J. Topol The importance of proteinuria as a determinant of mortality following percutaneous coronary revascularization in diabetics J. Am. Coll. Cardiol., April 1, 1999; 33(5): 1269 - 1277. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. A. Moore, M. Epstein, L. Agodoa, and L. D. Dworkin Current Strategies for Management of Hypertensive Renal Disease Arch Intern Med, January 11, 1999; 159(1): 23 - 28. [Abstract] [Full Text] [PDF]
|
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|
|
|
|
M. Ravid, D. Brosh, D. Ravid-Safran, Z. Levy, and R. Rachmani Main Risk Factors for Nephropathy in Type 2 Diabetes Mellitus Are Plasma Cholesterol Levels, Mean Blood Pressure, and Hyperglycemia Arch Intern Med, May 11, 1998; 158(9): 998 - 1004. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 T. Mandrup-Poulsen Recent advances: Diabetes BMJ, April 18, 1998; 316(7139): 1221 - 1225. [Full Text]
|
|
|
|
|
|
M.-A. Gall, P. Hougaard, K. Borch-Johnsen, and H.-H. Parving Risk factors for development of incipient and overt diabetic nephropathy in patients with non-insulin dependent diabetes mellitus: prospective, observational study BMJ, March 15, 1997; 314(7083): 783 - 783. [Abstract] [Full Text]
|
|
|
|
 |
|
 M. J. Franz Protein, Diabetes, and Nephropathy The Diabetes Educator, January 1, 1997; 23(5): 535 - 543. [PDF]
|
|
|
|
|
|
H.-H. Parving Initiation and Progression of Diabetic Nephropathy N. Engl. J. Med., November 28, 1996; 335(22): 1682 - 1683. [Full Text]
|
|
|
|
 |
|
 G. C. Groggel Diabetic Nephropathy Arch Fam Med, October 1, 1996; 5(9): 513 - 520. [Abstract] [PDF]
|
|
|
|
|
|
National High Blood Pressure Education Program Wor 1995 Update of the Working Group Reports on Chronic Renal Failure and Renovascular Hypertension Arch Intern Med, September 23, 1996; 156(17): 1938 - 1947. [Abstract] [PDF]
|
|
|
|
|
|
A. H. Rubenstein A 64-Year-Old Man With Adult-Onset Diabetes JAMA, September 11, 1996; 276(10): 816 - 822. [Abstract] [PDF]
|
|
|
|
|
|
G. Maschio, D. Alberti, G. Janin, F. Locatelli, J. F.E. Mann, M. Motolese, C. Ponticelli, E. Ritz, P. Zucchelli, and The Angiotensin-Converting-Enzyme Inhibition in Pr Effect of the Angiotensin-Converting-Enzyme Inhibitor Benazepril on the Progression of Chronic Renal Insufficiency N. Engl. J. Med., April 11, 1996; 334(15): 939 - 945. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
B. J. Materson ACE Inhibitors as a Shield Against Diabetic Nephropathy Arch Intern Med, February 12, 1996; 156(3): 239 - 240. [Abstract] [PDF]
|
|
|
|
|
|
M. Ravid, R. Lang, R. Rachmani, and M. Lishner Long-term Renoprotective Effect of Angiotensin-converting Enzyme Inhibition in Non--insulin-dependent Diabetes Mellitus: A 7-Year Follow-up Study Arch Intern Med, February 12, 1996; 156(3): 286 - 289. [Abstract] [PDF]
|
|
|
|
|
|
J. R. Sowers and M. Epstein Diabetes Mellitus and Associated Hypertension, Vascular Disease, and Nephropathy : An Update Hypertension, December 1, 1995; 26(6): 869 - 879. [Abstract] [Full Text]
|
|
|
|
|
|
J. G. Puig, L. M. Ruilope, and R. Ortega Antihypertensive Treatment Efficacy in Type II Diabetes Mellitus : Dissociation Between Casual and 24-Hour Ambulatory Blood Pressure Hypertension, December 1, 1995; 26(6): 1093 - 1099. [Abstract] [Full Text]
|
|
|
|
|
|
D. D. Maki, J. Z. Ma, T. A. Louis, and B. L. Kasiske Long-term Effects of Antihypertensive Agents on Proteinuria and Renal Function Arch Intern Med, May 22, 1995; 155(10): 1073 - 1080. [Abstract] [PDF]
|
|
|
|
|
|
C. M. Clark and D. A. Lee Prevention and Treatment of the Complications of Diabetes Mellitus N. Engl. J. Med., May 4, 1995; 332(18): 1210 - 1217. [Full Text] [PDF]
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|
|
|
|
N. B. Watts and L. S. Blevins Jr Endocrinology JAMA, June 1, 1994; 271(21): 1666 - 1668. [Abstract] [PDF]
|
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|
|
|
|
M. Lipkin Jr, R. N. Link, and M. D. Schwartz General Internal Medicine JAMA, June 1, 1994; 271(21): 1672 - 1673. [Abstract] [PDF]
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|
|
|
|
|
M. J. Carella, V. V. Gossain, and D. R. Rovner Early Diabetic Nephropathy: Emerging Treatment Options Arch Intern Med, March 28, 1994; 154(6): 625 - 630. [Abstract] [PDF]
|
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|
|
|
|
G. Viberti, C. E. Mogensen, L. C. Groop, J. F. Pauls, the European Microalbuminuria Captopril Study Grou, G. Boner, D. J. van Dyk, A. Lucas, R. Romero, I. Salinas, et al. Effect of Captopril on Progression to Clinical Proteinuria in Patients With Insulin-Dependent Diabetes Mellitus and Microalbuminuria JAMA, January 26, 1994; 271(4): 275 - 279. [Abstract] [PDF]
|
|
|
|
|
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K. C. Abbott, L. R. Sanders, and G. L. Bakris Microalbuminuria in Non--Insulin-Dependent Diabetes Mellitus: Implications for Renal Survival Arch Intern Med, January 24, 1994; 154(2): 146 - 153. [Abstract] [PDF]
|
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|
|
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|
 ACE INHIBITORS IN NORMOTENSIVE TYPE II DIABETES Journal Watch (General), April 27, 1993; 1993(427): 3 - 3. [Full Text]
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