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Review: ACE inhibitors delay microalbuminuria in diabetes without nephropathy and reduce mortality in diabetic nephropathy

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 Q Do antihypertensive agents prevent onset of microalbuminuria in patients with diabetes without nephropathy and delay progression in patients with diabetic nephropathy?

Clinical impact ratings GP/FP/Primary care ★★★★★★☆ IM/Ambulatory care ★★★★★★☆ Nephrology ★★★★★★☆ Cardiology ★★★★★★☆ Endocrine ★★★★★☆☆


Embedded ImageData sources:

Medline (1966 to September 2003), EMBASE/Excerpta Medica (1988 to September 2003), Cochrane Central Register of Controlled Trials (2004), reference lists, and authors in the field.

Embedded ImageStudy selection and assessment:

randomised controlled trials (RCTs) in any language comparing an antihypertensive agent with another antihypertensive agent or placebo in diabetic patients with and without nephropathy. 16 RCTs (n = 8570) in diabetic patients without nephropathy and 43 RCTs (n = 7545) in diabetic patients with nephropathy met the selection criteria. Quality assessment of individual studies was based on allocation concealment, intention to treat analysis, loss to follow up, and blinding.

Embedded ImageOutcomes:

onset of microalbuminuria, all cause mortality, end stage renal disease …

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