Efficacy of Aldosterone Antagonist with RAAS Blockade in Patients with Diabetic Kidney Disease

Arvind Gupta, U. Narain
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Abstract

Background: The use of an angiotensin-converting enzyme inhibitor or angiotensin receptor blocker is now standard therapy for patients with diabetic kidney disease. However, this treatment is not fully effective in some patients. Methods: A prospective observational study was conducted at SRN Hospital Allahabad on 600 diabetic kidney disease patients during July 2015 to August 2017 to compare the efficacy of triple blockade, double blockade and single blockade of renin-angiotensin-aldosterone system. Results: At the end of the study, 24 hours urinary protein excretion rate was statistically compared between group I & group III and between group II & group III. The rate was found significant with p value (<0.0001) and (0.0003) respectively. Conclusion: Triple blockade of the renin-angiotensin-aldosterone system was effective for the treatment of proteinuria in patients with diabetic kidney disease whose increased urinary protein had not responded sufficiently to a dual blockade.
醛固酮拮抗剂联合RAAS阻断治疗糖尿病肾病的疗效
背景:血管紧张素转换酶抑制剂或血管紧张素受体阻滞剂是目前糖尿病肾病患者的标准治疗方法。然而,这种治疗对某些患者并不完全有效。方法:2015年7月至2017年8月在阿拉哈巴德SRN医院对600例糖尿病肾病患者进行前瞻性观察研究,比较肾素-血管紧张素-醛固酮系统三阻断、双阻断和单阻断的疗效。结果:研究结束时,I组与III组、II组与III组24小时尿蛋白排泄率比较有统计学意义。p值分别为<0.0001和< 0.0003,差异有统计学意义。结论:肾素-血管紧张素-醛固酮系统的三重阻断对于尿蛋白增加未对双重阻断反应充分的糖尿病肾病患者的蛋白尿是有效的。
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