Renal risk and renoprotection among ethnic groups with type 2 diabetic nephropathy: A post hoc analysis of RENAAL

Renal risk and renoprotection among ethnic groups with type 2 diabetic nephropathy: A post hoc analysis of RENAAL

Author Zeeuw, D. de Google Scholar
Ramjit, D. Google Scholar
Zhang, Z. Google Scholar
Ribeiro, Artur Beltrame Autor UNIFESP Google Scholar
Kurokawa, K. Google Scholar
Lash, J. P. Google Scholar
Chan, J. Google Scholar
Remuzzi, G. Google Scholar
Brenner, B. M. Google Scholar
Shahinfar, S. Google Scholar
Institution Univ Groningen
Merck & Co Inc
Universidade Federal de São Paulo (UNIFESP)
Tokai Univ
Univ Illinois
Chinese Univ Hong Kong
Mario Negri Inst Pharmacol Res
Brigham & Womens Hosp
Harvard Univ
Abstract Type 2 diabetes is becoming the leading cause of end-stage renal disease ( ESRD) worldwide. Prevalence of ESRD and the antihypertensive response to renin-angiotensin system intervention are suggested to vary among different ethnicities. the Reduction in Endpoints in Non-insulin dependent diabetes mellitus with the Angiotensin II Antagonist Losartan (RENAAL) study, which included different ethnic groups, demonstrated a renoprotective effect of losartan. A post hoc analysis from RENAAL was performed where we examined in each ethnic group the ESRD risk, identified independent predictors for ESRD, effect of degree of baseline albuminuria, effect of 6-month antiproteinuric response to therapy on ESRD, and renoprotective effect of losartan assessed by albuminuria reduction and ESRD. Baseline albuminuria was the strongest predictor for ESRD in every ethnic group. Albuminuria reduction was associated with reduced risk of ESRD while losartan reduced albuminuria in every ethnic group. When accounting for independent predictors of ESRD, losartan exhibited renoprotection in all ethnic groups. in this type 2 diabetic population with nephropathy, baseline albuminuria is the predominant risk parameter for ESRD; early antiproteinuric effect of losartan predicts long- term renoprotection; and losartan appears to be renoprotective in all ethnic groups. Since the RENAAL study was not powered to determine ethnic responses, these results underline the need for prospective trials where the aim is renal protection among different ethnic groups.
Keywords albuminuria
proteinuria
ethnicity
type 2 diabetes
losartan
ESRD
Language English
Date 2006-05-01
Published in Kidney International. New York: Nature Publishing Group, v. 69, n. 9, p. 1675-1682, 2006.
ISSN 0085-2538 (Sherpa/Romeo, impact factor)
Publisher Nature Publishing Group
Extent 1675-1682
Origin http://dx.doi.org/10.1038/sj.ki.5000326
Access rights Open access Open Access
Type Article
Web of Science ID WOS:000237238400032
URI http://repositorio.unifesp.br/handle/11600/28856

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