Effect of antihypertensive treatment on kidney function in diabetic nephropathy

Abstract

The effect of long term, aggressive antihypertensive treatment on kidney function in diabetic nephropathy was studied prospectively in 11 insulin dependent diabetics (mean age 30). During the mean pretreatment period of 32 (range 23-66) months the g filtration rate decreased significantly and albuminuria and the arterial blood pressure increased significantly. During the 72 (range 32-91) month period of antihypertensive treatment the average arterial blood pressure fell from 143/96 mm Hg to 129/84 mm Hg and albuminuria decreased from 1038 ig/min to 504 jig/min. The rate of decline in the giomerular filtration rate decreased from 0*89 (range 0*44-1*46) ml/min/month before treatment to 0•22 (range 0-01-0•40) ml/min/month during treatment. The rate of decline in the giomerular filtration rate was significantly smaller during the second three years compared with the first three years in patients who received long term antihypertensive treatment (?. -6 years). One patient died from acute myocardial infarction (giomerular filtration rate 46 ml/min/ 1*74 m 2). Effective antihypertensive treatment postpones renal insufficiency in diabetic nephropathy. © 1987, British Medical Journal Publishing Group. All rights reserved.