Antihypertensive Treatment in NIDDM, with Special Reference to Abnormal Albuminuria
The deleterious effects of systemic blood pressure on glomerular structure were reported more than twenty years ago in a patient with NIDDM and unilateral renal artery stenosis, in which characteristic nodular diabetic glomerulosclerosis was present in the non-ischaemic kidney only . Nevertheless, to date the impact of antihypertensive therapy on renal injury in NIDDM has received little attention even though the cumulative incidence of persistent proteinuria and microalbuminuria in NIDDM subjects is comparable in frequency to IDDM subjects of similar duration [2–5]. The clinical relevance of these figures is reflected by statistics which now show that over 50% of patients entering renal replacement programs have NIDDM [6–8]. Furthermore, in NIDDM the relationship between nephropathy and hypertension is more complex than in IDDM, since hypertension is not necessarily linked to the presence of renal disease, and often precedes the diagnosis of diabetes.
KeywordsNIDDM Patient Persistent Proteinuria Dihydropyridine Calcium Channel Blocker Conventional Therapy Group Microalbuminuric Patient
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