Journal
CURRENT DIABETES REPORTS
Volume 10, Issue 4, Pages 297-305Publisher
CURRENT MEDICINE GROUP
DOI: 10.1007/s11892-010-0126-2
Keywords
Diabetes; Kidney; Diabetic kidney disease; Chronic kidney disease; Renin; Angiotensin II; Aldosterone; Angiotensin-converting enzyme inhibitors; Angiotensin II receptor blockers; Albuminuria; Microalbuminuria; Glomerular filtration rate
Categories
Funding
- Abbott Laboratories
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Blockade of the renin-angiotensin-aldosterone system (RAAS) prevents the development and progression of diabetic kidney disease (DKD). It is controversial whether the simultaneous use of two RAAS inhibitors (ie, dual RAAS blockade) further improves renal outcomes. This review examines the scientific rationale and current clinical evidence addressing the use of dual RAAS blockade to prevent and treat DKD. It is concluded that dual RAAS blockade should not be routinely applied to patients with low or moderate risk of progressive kidney disease (normoalbuminuria or microalbuminuria with preserved glomerular filtration rate). For patients with high risk of progressive kidney disease (substantial albuminuria or impaired glomerular filtration rate), clinicians should carefully weigh the potential risks and benefits of dual RAAS blockade on an individual basis until ongoing clinical trials provide further insight.
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