Angiotensin-converting enzyme inhibitors versus angiotensin receptor blockers for diabetic nephropathy: a retrospective comparison.

Introduction. There are no adequate head-to-head comparisons of angiotensin-converting enzyme (ACE) inhibitors and angiotensin receptor blockers (ARB) in type 2 diabetic patients in spite of some interesting attempts. Furthermore, there are no adequate studies about the effects of ACE inhibitors in type 2 diabetic patients, who are the great majority of diabetic individuals. This study has retrospectively compared the effects of ACE inhibitors and ARBs used to treat diabetic nephropathy in a group of type 2 diabetic subjects.Design and methods. Patients (n=154) were treated with ACE inhibitors (mean age 59.5±13.3 years, 52.6% were male). Eighty-five patients had been treated with ARBs from 1999 until now (mean age 62.6±10.9 years, 56.0% were male, differences not significant). Kaplan-Meier survival analysis was used to calculate survival before reaching end-stage renal disease (ESRD) (glomerular filtration < 15 ml/min, stage V of renal disease as defined by KDOQI clinical guidelines) or starting renal rep...