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A renoprotective effect of low dose losartan in patients with type 2 diabetes

Hideaki Sawaki1, Jungo Terasaki, Atsushi Fujita

  • 1First Department of Internal Medicine, Osaka Medical College, 2-7 Daigaku-machi, Takatsuki, Osaka 569-8686, Japan. h-sawaki@poh.osaka-med.ac.jp

Diabetes Research and Clinical Practice
|September 25, 2007
PubMed

Insights

Angiotensin II receptor blockers (ARBs) may directly protect kidneys in diabetic patients. This study suggests ARBs reduce proteinuria, indicating a direct renoprotective effect beyond blood pressure reduction.

Area of Science:

  • Nephrology
  • Endocrinology
  • Pharmacology

Background:

  • Diabetic nephropathy is a leading cause of kidney damage.
  • Angiotensin II receptor blockers (ARBs) are used to treat diabetic nephropathy.
  • The direct renoprotective effect of ARBs versus their blood pressure-lowering effect remains debated.

Purpose of the Study:

  • To investigate the direct effect of ARBs on diabetic nephropathy.
  • To assess the impact of losartan on proteinuria in type 2 diabetic patients with early kidney damage.

Main Methods:

  • A randomized controlled trial involving 34 type 2 diabetic patients with early kidney damage.
  • Patients were divided into a losartan group (25mg daily for 1 year) and a control group.
  • Urinary albumin/creatinine ratio (UACR) and blood pressure were measured before and during treatment.

Main Results:

  • The losartan group showed a significantly smaller increment in UACR compared to the control group (-23.8 vs. 15.9 mg/gCr, P=0.0114).
  • Mean blood pressure levels did not significantly change, although systolic blood pressure at home decreased slightly in the losartan group.
  • No significant differences were observed in HbA1c, fasting plasma glucose, lipid profiles, or BMI between groups.

Conclusions:

  • Losartan treatment led to a significant reduction in UACR in diabetic patients.
  • This suggests a direct renoprotective action of ARBs in diabetic nephropathy, independent of major blood pressure changes.
  • Further research is warranted to elucidate the precise mechanisms of ARB-induced renoprotection.

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