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Kdigo clinical practice guideline for the management of blood pressure in chronic kidney disease. Recommendation sor c, based on a meta-analysis of randomized controlled trials rcts with disease-oriented outcomes. Delellis, pharmd, bcps, manchester university college of pharmacy, natural, and health sciences, fort wayne, indiana lucas g.

Agha a, amer w, anwar e, bashir k. Arr absolute risk reduction ci confidence interval nnt number needed to treat the kidney disease improving global outcomes guideline recommends arbs or ace inhibitors for adults with ckd with or without diabetes who have a urinary albumin excretion rate of 30 to 300 mg per 24 hours and in whom blood pressure medications are indicated. The american diabetes association recommends ace inhibitors or arbs for nonpregnant patients with diabetes and microalbuminuria, but it makes no specific recommendations for blood pressure beyond its standard goals.

No study of patients with type 2 diabetes found a significant difference in blood pressure, a1c level, or body mass index between treated patients and the control group. A 2001 meta-analysis of 10 small rcts (n 698) described the effect of ace inhibitors vs. Rindfuss, pharmd, bcps, allegheny health network, west penn hospital care partner clinic, pittsburgh, pennsylvania joan nashelsky, mls, university of iowa center for human rights, iowa city, iowa does therapy with angiotensin-converting enzyme (ace) inhibitors or angiotensin receptor blockers (arbs) prevent progression to chronic kidney disease (ckd) in normotensive patients with microalbuminuria? Ace inhibitors reduce the risk of progression to macroalbuminuria in normotensive patients with microalbuminuria and type 1 diabetes mellitus.

The guideline recommends a blood pressure goal of 13080 mm hg or less in these patients. ). Regression to normal albuminuria occurred more often with ace inhibitors than with placebo (or 3.

Ravid m, savin h, jutrin i, bental t, lang r, lishner m. Reduction of microalbuminuria by using losartan in normotensive patients with type 2 diabetes mellitus a randomized controlled trial. Kdoqi clinical practice guideline for diabetes and ckd 2012 update published correction appears in clinical inquiries provides answers to questions submitted by practicing family physicians to the family physicians inquiries network (fpin).

The strength of recommendations and the level of evidence for individual studies are rated using criteria developed by the evidence-based medicine working group ( the complete database of evidence-based questions and answers is copyrighted by fpin. Ravid m, lang r, rachmani r, lishner m. Summary of randomized controlled trials of normotensive patients with type 2 diabetes mellitus and microalbuminuria reduction with losartan (101. Hill, pharmd, bcps, bcacp, the university of texas at austin college of pharmacy, austin, texas sarah l. .


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    Sano t, hotta n, kawamura t, et al. The strength of recommendations and the level of evidence for individual studies are rated using criteria developed by the evidence-based medicine working group ( the complete database of evidence-based questions and answers is copyrighted by fpin. A 2001 meta-analysis of 10 small rcts (n 698) described the effect of ace inhibitors vs. Long-term effect of ace inhibition on development of nephropathy in diabetes mellitus type ii. Recommendation sor c, based on a meta-analysis of randomized controlled trials rcts with disease-oriented outcomes.

    All studies demonstrated the benefits of therapy with ace inhibitors and arbs on urinary albumin excretion in patients with type 2 diabetes, but the magnitude of effect varied by comparison group. Several definitions of normotension were allowed microalbuminuria was defined as a urinary albumin excretion rate of 20 to 200 mcg per minute, whereas a rate greater than 200 mcg per minute was considered macroalbuminuria. Kdoqi clinical practice guideline for diabetes and ckd 2012 update published correction appears in clinical inquiries provides answers to questions submitted by practicing family physicians to the family physicians inquiries network (fpin). Rindfuss, pharmd, bcps, allegheny health network, west penn hospital care partner clinic, pittsburgh, pennsylvania joan nashelsky, mls, university of iowa center for human rights, iowa city, iowa does therapy with angiotensin-converting enzyme (ace) inhibitors or angiotensin receptor blockers (arbs) prevent progression to chronic kidney disease (ckd) in normotensive patients with microalbuminuria? Ace inhibitors reduce the risk of progression to macroalbuminuria in normotensive patients with microalbuminuria and type 1 diabetes mellitus. Should all patients with type 1 diabetes mellitus and microalbuminuria receive angiotensin-converting enzyme inhibitors? A meta-analysis of individual patient data.

    Agha a, amer w, anwar e, bashir k. Corbo, pharmd, bcps, south texas veterans health care system, san antonio, texas teresa m. Kdigo clinical practice guideline for the management of blood pressure in chronic kidney disease. Hill, pharmd, bcps, bcacp, the university of texas at austin college of pharmacy, austin, texas sarah l. Delellis, pharmd, bcps, manchester university college of pharmacy, natural, and health sciences, fort wayne, indiana lucas g. Answers are drawn from an approved set of evidence-based resources and undergo peer review. Impediment of the progressions of microalbuminuria and hyperlipidemia in normotensive type 2 diabetes by low-dose ramipril. Ace inhibitors and arbs reduce the risk of progression to macroalbuminuria in normotensive patients with microalbuminuria and type 2 diabetes. . The authors of this meta-analysis and several of the referenced studies received funding from industry.

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