Effect of the combination of angiotensin receptor [AR] inhibitor and statin in patients with diabetic nephropathy

Despite the covencing evidence that antihypertensive treatment particularly with angiotensin converting enzyme [ACE] inhibitor, and angiotensin receptor [AR] blocker intrferes with renal disease progression, progression still cannot be completely halted, and there is a dire need for additional therapeutic intervention. Several studies have revealed the effects of statins in diabetic nephropathy. Therefore we evaluate the short-term effect of the combination of AR blocker [valsartan] and statin [simvastatin] in patients with DN. We included 24 normolipidemic patients with diabetic nephropathy. 9 of them are type I diabetes mellitus [DM], and 15 of them are type 2 DM. Each patient followed up for 3 months on valsartan [160mg /day], then for 6 months with addition of simvastatin [20 mg /day]. In simvastatin treatment' patients, proteinuria was significantly reduced by 56% [from 1242 +/- 524 to 553 +/- 314, p<0.0001] compared with baseline values. The present study demonstrates that statin [simvastatin] administration was associated with further reduction of proteinuria in normolipidemic diabetic patient already on AR blocker [valsartan]