Published Paper Details:

ABSTRACT: Diabetic kidney disease is an emerging epidemic of hypertension, diabetes mellitus, and obesity. It usually occurs slowly and gets worse for many years. The RAAS system is a hormone system that regulates blood pressure, fluid and electrolyte balance, and systemic vascular resistance. A Renoprotective effect is exerted that is independent of the blood pressure reduction caused by RAAS inhibition. Combination of ACE and AT II receptor antagonists to maximize RAAS inhibition and reduce proteinuria and GFR decline in diabetic and nondiabetic renal disease. According to recent trials, there is a benefit in slowing nephropathy progression in the presence of albuminuria. An approach including lifestyle modifications may achieve remission of proteinuria and stabilization of renal function in a substantial proportion of patients with proteinuria renal disease with RAAS inhibition combined with intensified amelioration of dyslipidemia. Independent of blood pressure reduction, a renal protective effect is exerted by RAAS inhibition using proteinuria as an endpoint compared to the effects of ARBS or ACE-1 as monotherapy or with a combination of both ACE-1 and ARB therapy. Most studies suggest that combination therapy provides a greater antiproteinuric effect than monotherapy, despite the methodological limitations, because of more prolonged and complete RAAS inhibition. Combination therapy has higher efficiency than monotherapy and is also associated with a higher incidence of adverse effects.