Effect of Irbesartan on Delaying Progression of Nephropathy in Patients with Concurrent Diabetic Nephropathy and Hypertension / 中国医科大学学报

ABSTRACT

Objective To evaluate the effect of irbesartan treatment on progression of nephropathy in patients with concurrent diabet-ic nephropathy (DN) and high blood pressure (HBP).Methods This study enrolled 180 patients with DN and HBP in a single-center,randomized,parallel group clinical trial.All patients were randomized in a 1 ∶ 1 ratio to irbesartan and amlodipine groups,using a software-generated block randomization method.Results After 12 months of treatment,the estimated glomerular filtration rate (eGFR) in the irbesartan group was markedly lower than in the amlodipine group (P =0.026).When grouped according to the Chronic Kidney Disease (CKD) Epidemiology Collaboration equation,results showed that in stage 1-2 CKD and stage 3 CKD patients,reductions in eGFR in the irbesartan group were notably less than in the amlodipine group (P =0.009 and P =0.028,respectively).At 12 months,the decrease in urinary protein excretion (g/24 h) in the irbesartan group was obviously greater than in the amlodipine group (P ＜ 0.001);however,no difference in reduction of systolic and diastolic BP was found between groups (P =0.534 and P =0.386,respectively).Conclusion Irbesartan can ameliorate the progression of nephropathy in patients with concurrent DN and HBP to some extent.