Please use this identifier to cite or link to this item: https://ahro.austin.org.au/austinjspui/handle/1/9822
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dc.contributor.authorJerums, Georgeen
dc.contributor.authorAllen, Terri Jen
dc.contributor.authorCampbell, D Jen
dc.contributor.authorCooper, Mark Een
dc.contributor.authorGilbert, Richard Een
dc.contributor.authorHammond, J Jen
dc.contributor.authorO'Brien, R Cen
dc.contributor.authorRaffaele, Jen
dc.contributor.authorTsalamandris, Conen
dc.date.accessioned2015-05-15T23:04:35Z
dc.date.available2015-05-15T23:04:35Z
dc.date.issued2004-11-01en
dc.identifier.citationDiabetic Medicine : A Journal of the British Diabetic Association; 21(11): 1192-9en
dc.identifier.govdoc15498085en
dc.identifier.otherPUBMEDen
dc.identifier.urihttps://ahro.austin.org.au/austinjspui/handle/1/9822en
dc.description.abstractTo assess the efficacy of an angiotensin converting enzyme (ACE) inhibitor (perindopril), a dihydropyridine calcium channel blocker (sustained release nifedipine) and placebo in preventing the progression of albuminuria and decline in glomerular filtration rate (GFR) in patients with Type 2 diabetes and microalbuminaria.A prospective, randomized, open, blinded end point study of 77 patients allocated to three treatment groups (23 perindopril, 27 nifedipine, 27 placebo). Drug doses were adjusted to achieve a decrease in diastolic blood pressure (DBP) of 5 mmHg in the first 3 months and additional therapy was given if hypertension developed (supine DBP > 90 mmHg and/or systolic blood pressure (SBP) > 140 mmHg if < or = 40 years; supine DBP > 90 mmHg and/or SBP > 160 mmHg if > 40 years). Median follow-up was 66 months, with 37 patients being followed for at least 6 years.Blood pressure remained within the non-hypertensive range in 83% of perindopril-, 95% of nifedipine- and 30% of placebo-treated patients (P < 0.01). In the first 12 months albumin excretion rate (AER) decreased by 47% only in the perindopril group (P = 0.04). From 12 to 72 months, AER gradients increased by 27% per year only in the placebo group (P < 0.01). After 6 years, macroalbuminuria had developed in 7/15 placebo compared with 2/11 in perindopril and 1/11 nifedipine-treated patients (P = 0.05). GFR did not change in the first 12 months, but thereafter the median GFR gradient (ml/min/1.73 m(2) per year) was -2.4 (P < 0.01) for perindopril-, -1.3 (P = 0.26) for nifedipine- and -4.2 (P = 0.01) for placebo-treated patients. The rate of decline in GFR for the study group as a whole from 12 months to the end of follow-up correlated negatively with mean arterial pressure (MAP) (r = -0.38, P < 0.01). During a 3-month treatment pause in 29 patients AER tended to increase only in the perindopril group (P < 0.07).Long-term control of blood pressure with perindopril or nifedipine stabilizes AER and attenuates GFR decline in proportion to MAP in non-hypertensive patients with Type 2 diabetes and microalbuminuria.en
dc.language.isoenen
dc.subject.otherAdulten
dc.subject.otherAlbuminuria.drug therapy.physiopathologyen
dc.subject.otherAngiotensin-Converting Enzyme Inhibitors.therapeutic useen
dc.subject.otherCalcium Channel Blockers.therapeutic useen
dc.subject.otherDiabetes Mellitus, Type 2.drug therapy.physiopathologyen
dc.subject.otherDiabetic Nephropathies.drug therapy.physiopathologyen
dc.subject.otherDisease Progressionen
dc.subject.otherDouble-Blind Methoden
dc.subject.otherFemaleen
dc.subject.otherGlomerular Filtration Rate.drug effectsen
dc.subject.otherHumansen
dc.subject.otherHypertension.prevention & controlen
dc.subject.otherMaleen
dc.subject.otherMiddle Ageden
dc.subject.otherNifedipine.therapeutic useen
dc.subject.otherPerindopril.therapeutic useen
dc.subject.otherProspective Studiesen
dc.titleLong-term renoprotection by perindopril or nifedipine in non-hypertensive patients with Type 2 diabetes and microalbuminuria.en
dc.typeJournal Articleen
dc.identifier.journaltitleDiabetic medicine : a journal of the British Diabetic Associationen
dc.identifier.affiliationDepartment of Medicine, University of Melbourne, and Endocrinology Unit, Austin Health, Studley Road, Heidelberg, 3084 Victoria, Australiaen
dc.identifier.doi10.1111/j.1464-5491.2004.01316.xen
dc.description.pages1192-9en
dc.relation.urlhttps://pubmed.ncbi.nlm.nih.gov/15498085en
dc.contributor.corpauthorMelbourne Diabetic Nephropathy Study Groupen
dc.type.austinJournal Articleen
local.name.researcherJerums, George
item.openairecristypehttp://purl.org/coar/resource_type/c_18cf-
item.cerifentitytypePublications-
item.fulltextNo Fulltext-
item.grantfulltextnone-
item.languageiso639-1en-
item.openairetypeJournal Article-
crisitem.author.deptEndocrinology-
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