ANGIOTENSIN-CONVERTING ENZYME-INHIBITORS AND PROGRESSION OF DIABETIC NEPHROPATHY

A number of studies have examined the effects of angiotensin-converting enzyme (ACE) inhibitors on progression of diabetic renal disease and microalbuminuria in both normotensive and hypertensive patients with Type I diabetes. Four moderately sized, prospective trials in normotensive patients with Type I diabetes, however, clearly show that ACE inhibitors reduce microalbuminuia and preserve renal function without reducing arterial pressure. These studies also show that reductions in microalbuminuria correlate with preservation of renal function. The current study by Ravid and colleagues, in this issue of Annals, is the first to show that ACE inhibitors reduce microalbuminuria and slow progression of renal disease in normotensive patients with Type II diabetes.