Effect of ACE inhibitors on creatinine clearance and albuminuria in diabetic nephropathy

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]. 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