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Renal protection by angiotensin II receptor antagonists in patients with type 2 diabetes

Roger E Peverill
Med J Aust 2002; 176 (6): . || doi: 10.5694/j.1326-5377.2002.tb04416.x
Published online: 18 March 2002

To the Editor: A recent editorial in the Journal attempted to define a role for angiotensin II receptor (AIIR) antagonists in patients with type 2 diabetes.1 This was in the light of recent trial evidence that these agents reduce progression to renal failure in patients with type 2 diabetes and diabetic renal disease. Unfortunately, the guidelines provided were somewhat confusing and fragmented. I believe that a simpler treatment guide can be constructed, particularly when it is emphasised that the aim in diabetes is to use agents that prevent not only renal failure but also cardiovascular events.


  • Centre for Heart and Chest Research, Monash University Department of Medicine, Monash Medical Centre, Clayton, VIC.



  • 1. Jerums G, Cooper ME, Gilbert RE, Atkins RC. Renal protection by angiotensin II receptor antagonists in patients with type 2 diabetes [editorial]. Med J Aust 2001; 175: 397-399.
  • 2. Heart Outcomes Prevention Evaluation (HOPE) Investigators. Effects of ramipril on cardiovascular and microvascular outcomes in people with diabetes mellitus: results of the HOPE study and MICRO-HOPE substudy [published correction appears in Lancet 2000; 356: 860]. Lancet 2000; 355: 253-259.
  • 3. Ravid M, Savin H, Jutrin I, et al. Long-term stabilizing effect of angiotensin-converting enzyme inhibition on plasma creatinine and on proteinuria in normotensive type II diabetic patients. Ann Intern Med 1993; 118: 577-581.
  • 4. Ravid M, Lang R, Rachmani R, Lishner M. Long-term renoprotective effect of angiotensin-converting enzyme inhibition in non-insulin-dependent diabetes mellitus. A 7-year follow-up study. Arch Intern Med 1996; 156: 286-289.
  • 5. Ruggenenti P, Perna A, Gherardi G, et al. Renoprotective properties of ACE-inhibition in non-diabetic nephropathies with non-nephrotic proteinuria. Lancet 1999; 354: 359-364.

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