Review: Dual blockade of renin-angiotensin system in diabetic nephropathy: review of literature and local experience

Abstract

Albuminuria and hypertension are predictors of poor renal and cardiovascular outcome in patients with diabetic nephropathy (DN). Intensive treatment requires blockade of the renin-angiotensin system (RAS) by either angiotensin-converting enzyme (ACE) inhibitors or angiotensin receptor blockers (ARB), which reduce blood pressure and proteinuria. Combining the two therapies has shown greater benefits than either drug alone to reduce progression of DN. Although treatment goals are more likely to be achieved with the combination, this requires close monitoring of serum creatinine and potassium which invariably rise on such therapy.