CARI-Australia
2000
|
• ACEi independent of blood pressure and GFR in:
1. diabetes mellitus type 1 and 2 complicated by
microalbuminuria or overt nephropathy
2. hypertensive diabetics without albuminuria
3. no specific ACE advantage beyond class effect
4. combination therapy no specific benefit beyond antihypertensive benefit
5. non-dihydropyridine calcium channel blockers offer a small protective effect on proteinuria in diabetic nephropathy, beyond their antihypertensive action
• No evidence for specific benefit of ARB in diabetic
nephropathy; ARB are indicated in patients intolerant to ACEi
|
Prevention of progression of kidney disease
19: ACE inhibitor treatment in diabetic
nephropathy
20: Angiotensin II antagonists
21. ACE inhibitor and Angiotensin II Antagonist Combination Treatment
23. Specific Effects of Calcium Channel Blockers in Diabetic Nephropathy
|
Evidence
level A, type 1>2
No evidence for an advantage of a specific ACEi
Insufficient evidence for ACEi treatment in diabetics with
normal blood pressure or normal urinary albumin
Level A evidence (Type II diabetes)
|
KDOQI-US
2004 |
• ACEi or ARB in:
1. Diabetic kidney disease, with or without hypertension
2. Nondiabetic kidney disease and spot urine total
protein/creatinine ≥ 200 mg/g, with or without hypertension |
Clinical
Practice Guidelines on Hypertension and Antihypertensive agents
in Chronic Kidney Disease
Guideline 8. Pharmacological therapy: diabetic kidney disease
Guideline 9. Pharmacological therapy: nondiabetic kidney disease
|
Evidence level A
Evidence level A and C |
