PMID- 17899953
OWN - NLM
STAT- MEDLINE
DCOM- 20071108
LR  - 20220408
IS  - 2676-1319 (Print)
IS  - 2676-1319 (Linking)
VI  - 9
IP  - 2
DP  - 2007 Jun
TI  - Use of losartan in reducing microalbuminuria in normotensive patients with type-2 
      diabetes mellitus.
PG  - 79-83
AB  - Type-2 diabetes mellitus (T2DM) is a global disease and its resultant 
      complication, diabetic nephropathy, is a leading cause of chronic renal failure. 
      Microalbuminuria is an early indicator of diabetic nephropathy and is also an 
      independent risk factor for cardiovascular morbidity. Data have shown that 
      anti-hypertensives like Angiotensin receptor blockers (ARB), and Angiotensin 
      converting enzyme inhibitors (ACEI) reduce microalbuminuria and retards the 
      progression of renal disease effectively in hypertensive T2DM patients. But the 
      effects ofARBs on preventing microalbuminuria and ensuing nephropathy in 
      normotensive patients with T2DM is yet to be fully established. To assess the 
      anti-microalbuminuric effects of losartan therapy in normotensive T2DM patients. 
      Interventional Phase Two Clinical Trial was done. Study was done at Diabetic 
      Clinic, Jinnah Hospital Lahore, Pakistan over 8 months. A total of 171 
      normotensive patients with T2DM and microalbuminuria were evaluated. After 
      informed consent and baseline 24-hour urinary microalbuminuria quantification the 
      selected patients were started on losartan 50 mg/day for a six-month period. 
      Monthly follow-ups were done to monitor the blood pressure, glycemic control, 
      urea/creatinine/potassium levels and any untoward effects of losartan therapy. 
      Quantitative microalbuminuria was repeated at the end of study. Out of the 171 
      patients, 149 (87.1%) had significant albuminuria reduction >30.0% of their 
      baseline and the variable of final outcome of intervention (urinary albumin in 
      mg/dl) was significantly reduced (Mean 101.9 +/- SD 21.7 baseline and 47.5 +/- 
      12.9 post therapy) with p<0.001 and with minimal side-effects. These 
      anti-albuminuric effects of losartan were reversible as seen on rechecking the 
      urinary albumin two months after discontinuation of treatment. Losartan was well 
      tolerated and demonstrated significant anti-proteinuric effects in patients with 
      T2DM with early nephropathy independent of hypertension, warranting further 
      long-term large-scale studies to prove its usefulness as preventive therapy for 
      diabetic nephropathy.
FAU - Agha, Adnan
AU  - Agha A
AD  - Medical Unit I, Jinnah Hospital, Lahore, Pakistan. adnanagha@hotmail.com
FAU - Bashir, Kaukab
AU  - Bashir K
FAU - Anwar, Eram
AU  - Anwar E
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
PL  - Nepal
TA  - Nepal Med Coll J
JT  - Nepal Medical College journal : NMCJ
JID - 101129937
RN  - 0 (Angiotensin II Type 1 Receptor Blockers)
RN  - 0 (Antihypertensive Agents)
RN  - JMS50MPO89 (Losartan)
SB  - IM
MH  - Albuminuria/*drug therapy/physiopathology
MH  - Angiotensin II Type 1 Receptor Blockers/pharmacology/*therapeutic use
MH  - Antihypertensive Agents/*therapeutic use
MH  - Blood Pressure/drug effects
MH  - Diabetes Mellitus, Type 2/*physiopathology
MH  - Diabetic Nephropathies/*prevention & control
MH  - Disease Progression
MH  - Female
MH  - Humans
MH  - Losartan/pharmacology/*therapeutic use
MH  - Male
MH  - Middle Aged
MH  - Prospective Studies
MH  - Risk Factors
MH  - Time Factors
EDAT- 2007/09/29 09:00
MHDA- 2007/11/09 09:00
CRDT- 2007/09/29 09:00
PHST- 2007/09/29 09:00 [pubmed]
PHST- 2007/11/09 09:00 [medline]
PHST- 2007/09/29 09:00 [entrez]
PST - ppublish
SO  - Nepal Med Coll J. 2007 Jun;9(2):79-83.