PMID- 19414946 OWN - NLM STAT- MEDLINE DCOM- 20090707 LR - 20131121 IS - 1319-2442 (Print) IS - 1319-2442 (Linking) VI - 20 IP - 3 DP - 2009 May TI - Reduction of microalbuminuria by using losartan in normotensive patients with type 2 diabetes mellitus: A randomized controlled trial. PG - 429-35 AB - Type 2 diabetes mellitus (T2DM) is a worldwide pandemic that may lead to diabetic kidney disease (DKD), a complication which is the single most important and globally prevalent cause of chronic kidney disease. Microalbuminuria has been shown to be an early indicator of DKD and data suggest that angiotensin receptor blockers (ARBs) reduce urinary albumin excretion and retard the progression of renal disease in hypertensive T2DM patients. However, the effects of ARBs on preventing microalbuminuria and ensuing DKD in normotensive patients with T2DM is yet to be fully established. The objective of this study is to assess the anti-microalbuminuric effects of losar-tan therapy versus placebo in normotensive T2DM patients. This randomized single blinded controlled trial was performed at the Diabetic Clinic, Jinnah Hospital, Lahore over a period of 10 months. A total of 361 normotensive patients with T2DM and microalbuminuria were selected; of them, 171 patients were randomly allocated to the test group and 190 enrolled into the control group. The patients in the test group were started on losartan 50 mg/day for a six month period while those in the control group were put on vitamin B-12 500 mcg/day. The patients as well as the primary attending phy-sicians/lab evaluators were blinded to the study. All study patients were followed up on a monthly basis. Quantitative microalbuminuria was tested at the beginning and at the end of the study. Out of the 171 patients in the test group, 149 (87.1%) had significant reduction of albuminuria by > 30% of their baseline (mean 101.9 +/- 21.7 baseline and, 47.5 +/- 12.9 post-therapy). The corresponding values for albuminuria in the 190 patients in the control group was mean 104.7 +/- 26.3 baseline and post 6-month mean 103.9 +/- 22.9, with P< 0.0001. The anti-albuminuric effect of losartan was reversible as seen on re-checking the urinary albumin two months after discontinuation of treatment. Our study shows that losartan was well tolerated and demonstrated significant anti-proteinuric effects in patients with T2DM with early nephropathy independent of hypertension. FAU - Agha, Adnan AU - Agha A AD - Jinnah Hospital, Lahore, Pakistan. adnanagha@hotmail.com FAU - Amer, Wasim AU - Amer W FAU - Anwar, Eram AU - Anwar E FAU - Bashir, Kaukab AU - Bashir K LA - eng PT - Journal Article PT - Randomized Controlled Trial PT - Research Support, Non-U.S. Gov't PL - Saudi Arabia TA - Saudi J Kidney Dis Transpl JT - Saudi journal of kidney diseases and transplantation : an official publication of the Saudi Center for Organ Transplantation, Saudi Arabia JID - 9436968 RN - 0 (Angiotensin II Type 1 Receptor Blockers) RN - 0 (Vitamins) RN - JMS50MPO89 (Losartan) RN - P6YC3EG204 (Vitamin B 12) SB - IM MH - Adult MH - Aged MH - Albuminuria/etiology/physiopathology/*prevention & control MH - Angiotensin II Type 1 Receptor Blockers/*therapeutic use MH - Blood Pressure MH - Diabetes Mellitus, Type 2/complications/*drug therapy/physiopathology MH - Diabetic Nephropathies/etiology/physiopathology/*prevention & control MH - Female MH - Humans MH - Losartan/*therapeutic use MH - Male MH - Middle Aged MH - Single-Blind Method MH - Time Factors MH - Treatment Outcome MH - Vitamin B 12/therapeutic use MH - Vitamins/therapeutic use EDAT- 2009/05/06 09:00 MHDA- 2009/07/08 09:00 CRDT- 2009/05/06 09:00 PHST- 2009/05/06 09:00 [entrez] PHST- 2009/05/06 09:00 [pubmed] PHST- 2009/07/08 09:00 [medline] AID - SaudiJKidneyDisTranspl_2009_20_3_429_50774 [pii] PST - ppublish SO - Saudi J Kidney Dis Transpl. 2009 May;20(3):429-35.