Effect of ACE inhibitors on Creatinine Clearance and albuminuria in diabetic nephropathy

Document Type : Original Article

Author

Internal Medicine Department Ain Shams University

Abstract

30 diabetic female patients were studied for the effect of Ramipril on creatinine clearance and albuminuria, they all were type 2 diabetes mellitus and were on oral hypoglycemic drugs. They all had variable degrees of hypertenison. Ramipril was taken for 3 months in a variable doses between 5 and 10 mg/day. Creatinine clearance and albuminuria were determined before and after treatment. Patients were divided into 3 groups:
Group 1: 10 patients with albuminuria and mild hypertension.
Group 2: 10 patients with albuminuria and moderate hypertension.
Group 3: 10 patients with macroalbuminuria and moderate to severe hypertension.
In our study, Group 1 has made maximum benefit of Ramipril as regards highly significant decrease (P= .002) of creatinine clearance and of albuminuria which improved significantly (P=.001).
Group 2 had a lesser success with only decrease of albuminuria significantly (P=.005) but with insignificant decrease of level of creatinine clearance.
Group 3 with macroalbuminuria did not benefit from Ramipril effect on albuminuria but there was a significant decrease in creatinine clearance below normal levels (P=.001).
Conclusion: Early and tight control of blood pressure by Ramipril is needed to achieve a success in treating diabetic nephropathy with microalbuminuria. In our study, patients with macroalbuminuria did not benefit from Ramipril treatment.

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