I’ve heard there is a new type of drug called an antigiotensin II receptor blocker that may delay kidney failure in diabetics. As a type 1 diabetic on Altace 2.5 mg every day, I am wondering whether this medicine would be beneficial to me to delay kidney failure. Of course, I would also check with my nephrologist.
My kidney function – I was born with only one – is usually measured at a creatinine level of 1.3, and I have been a diabetic since age 18. Thanks for any information that you can supply.
A: Antigiotensin II receptor blockers (ARBs) have been used for hypertension for several years, but there are not as many studies that show their effect for diabetics. In another year or so that may change, but I think your physicians will agree that you should stick with the Altace for now.
Diabetic nephropathy develops in approximately 40% of all patients with Type 2 diabetes and has become the leading cause of renal failure in the United States. Spilling of protein (microalbumin) in the urine is one of the earliest signs of diabetic kidney disease.
A study was published in the New England Journal of Medicine in September 2001 that showed that use of irbesartan in hypertensive patients with type 2 diabetes and low levels of protein in the urine delayed the onset of kidney problems. Irbesartan is an angiotensin receptor blocker, different from the angiotensin converting enzyme (ACE) inhibitors that have been previously shown to lower blood pressure and protect the kidneys.
An analysis of 10 major studies in Type 1 diabetics showed that patients taking ACE inhibitors reduced their protein excretion rates by 50%. The best and most convincing evidence for preventing and delaying diabetic renal disease in Type 1 diabetics is still with the use of ACE inhibitors, such as the Altace that you are taking.
