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Lowering BP reduces risk of renal events in patients with type 2 diabetes, regardless of baseline BP, findings show
What's This?
Reducing blood pressure (BP) with the combination of an angiotensin-converting enzyme inhibitor and a diuretic seems to reduce the risk of renal events in patients with type 2 diabetes, even in patients with BP levels below currently recommended targets, according to an analysis of renal outcomes in the ADVANCE trial. During the ADVANCE trial, 11,140 individuals aged >=55 years with type 2 diabetes were randomized to receive perindopril plus indapamide (2 mg/0.625 mg for the first 3...
Reducing blood pressure (BP) with the combination of an angiotensin-converting enzyme inhibitor and a diuretic seems to reduce the risk of renal events in patients with type 2 diabetes, even in patients with BP levels below currently recommended targets, according to an analysis of renal outcomes in the ADVANCE trial.
During the ADVANCE trial, 11,140 individuals aged >=55 years with type 2 diabetes were randomized to receive perindopril plus indapamide (2 mg/0.625 mg for the first 3 months, with the dosage doubled thereafter) or placebo. The researchers noted that the trial had no inclusion or exclusion criteria with regard to BP, albuminuria rate, renal function, or use of BP-lowering agents.
The main outcome of the analysis was a composite of renal outcome events (new-onset microalbuminuria, new-onset nephropathy, doubling of serum creatinine levels to >200 mcmol/L, or end-stage renal disease).
During a mean follow-up of 4.3 years, active treatment reduced the risk of the composite outcome measure by 21% (hazard ratio [HR], 0.79; 95% CI, 0.73-0.85; P<.0001). This reduction in risk, the authors noted, was driven primarily by reduced risks of both micro- and macroalbuminuria.
The effects of treatment were consistent in subgroup analyses of patients stratified by baseline BP, even in those patients with a baseline BP of <120/70 mm Hg.
"In absolute terms, this simple, well-tolerated treatment strategy prevented 1 renal event among every 20 patients who were treated for 5 years, with no selection of patients on the basis of BP or BP-lowering treatment," the authors concluded. "These data therefore suggest that BP lowering may be considered routinely for the prevention of renal complications in all patients with diabetes, regardless of the baseline BP level."
This article was published online Feb. 18 ahead of print in the Journal of the American Society of Nephrology by de Galan BE, et al.
This research was funded in part by Servier.
Drugs that lower BP reduce cardiovascular morbidity, mortality in patients undergoing dialysis, meta-analysis finds 
What's This?
Blood pressure (BP)-lowering agents should be standard therapy for patients who are undergoing dialysis, a group of Australian and Dutch researchers suggest.Since there has been uncertainty about the usefulness and tolerability of reducing BP in this patient population, the investigators conducted a systematic review and meta-analysis to clarify the issue. They found 8 randomized controlled trials from 1950 to November 2008 that evaluated BP-lowering agents and recorded...
High serum phosphorus levels represent potential risk factor for coronary artery atherosclerosis in young adults, research indicates
What's This?
In healthy young adults, higher serum phosphorus levels--even those that fall within the normal range--are a possible risk factor for coronary artery atherosclerosis, new study data suggest.Although animal studies and observational studies of patients on dialysis have linked higher serum phosphate levels to vascular disease, the question as to whether phosphate levels in patients with normal kidney function are linked to coronary artery calcium levels has not been studied, the...
Low testosterone levels negatively affect mortality risk among males on dialysis, new data reveal
What's This?
Among men on hemodialysis, lower levels of testosterone are associated with a higher risk of all-cause mortality and cardiovascular disease (CVD)-related mortality, study results indicate.Men who undergo treatment with dialysis have an elevated risk of premature CVD, and in the general population, low concentrations of testosterone have been linked to cardiovascular risk, the authors of the study noted.
To assess the relationship between testosterone...
Early decline in kidney function following heart transplantation predictor of death, dialysis, study shows
What's This?
An early decline in estimated creatinine clearance (CrCl) within the first year following heart transplantation is a strong predictor of chronic dialysis and mortality >1 year after the procedure, according to recently published study results.Chronic kidney disease (CKD) continues to be a significant, unsolved complication of heart transplantation, the authors explained.
To determine whether an early decline in kidney function could be a predictor of progression...
American Society of Nephrology 2008 Renal Week
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