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TÎP 2 DÎYABETÎKMÎROALBUMÜNÎRÎK HASTALARDA LOSARTAN VE ENALAPRİLÎN ÜRÎNER ALBÜMÎN EKSKRESYONU ÜZERÎNE ETKÎLERÎ

THE EFFECTS OF LOSARTAN AND ENALAPRIL ON URINARY ALBUMIN EXCREATION (UAE) IN TYPE H DIABETIC - MICRO ALBUMINURIC PATIENTS

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Abstract (2. Language): 
Type IIdiabetic 32patients (21F, 11 M; aged 54 ±8 years) with mild-moderate hypertensive and persistent microalbuminuric were enrolled to the study. The diagnosis of diabetes had been done at least 5 years ago and the all patients were taking oral antidiabetic drugs. The patients using antihypertensive drugs during the last month were excluded from the study. The patients were fallen into two groups matched with age and weight. Losartan (50 mg/day) as an angiotensin receptor antagonist was given to the first group and enalapril (10 mg/day) was given to the second group with a duration of 6 months. UAE and BP levels were similar in both groups at the beginning. There were no significant changes in HbA\C, serum creatinine, uric acid and potassium levels during the treatment period. It was found that not only both drugs decreased blood pressure effectively, but they also decreased UAE significantly, while there was 60% decrease in UAE compared to the beginning values in the enalapril group, the rate of decrease in losartan group was 71 (%). UAE values decreased to the normoalbuminuric levels in more than half of the patient in both groups. But, we couldn't find any significant differences between two drugs interms of these effects.
Abstract (Original Language): 
Bu çalışmada, tip 2 diyabetik hipertansif 'hastalarda losartan ve enalaprilin mikroalbuminüri üzerine etkileri araştırıldı. Persistan mikroalbuminürisi olan hafif- orta derecede hipertansif tip 2 diyabetik 32 hasta (21K, 11 E; yaş ortalaması 54+8 yıl) çalışmaya alındı. Hastaların en az 5yıldır tip 2 diyabeti mevcuttu ve tüm hastalar oral antidiyabetik kullanmaktaydı. Son 1 ay içerisinde antihipertansif kullanan hastalar çalışmaya alınmadı. Hastalar 2 gruba ayrıldı. Birinci gruba 50 mg/gün losartan, 2. gruba ise 10 mg/gün enalapril 6 ay süreyle verildi. Başlangıçta 2 grup arasında yaş, vücut ağırlığı, üriner albumin atılımı (UAE) ve kan basıncı düzeyleri yönünden farklılık yoktu. HbAlC, serum kreatinin, serum ürik asit, ve potasyum düzeylerinde tedavi süresince değişiklik görülmedi. Her iki ilacında hem kan basıncını anlamlı düzeyde düşürdüğü hem de UAE'yi önemli derecede azalttığı tespit edildi. Enalapril grubunda başlangıç değerleriyle karşılaştırıldığında UAE'de %60 azalma varken, losartan grubunda bu oran %71 idi. UAE değerleri her iki gruptada hastaların yarısından fazlasında normoalbuminürik düzeylere düştü. Ama her iki grup arasında bu etkiler bakımından anlamlı fark saptanmadı. Kan basıncı tüm hastalarda her iki gruptada monoterapi ile normotansif düzeylere indi. Ama iki ilaç arasında kan basıncına ve UAE'na etki bakımından herhangi bir farklılık tespit edilemedi.
FULL TEXT (PDF): 
48-51

REFERENCES

References: 

1. Mogensen CE. Microalbuminuria predicts clinical proteinuria and early mortality in maturity-onset diabetes. N Eng J Med 1984; 310:356-360.
2. Dinneen SF, Gerstein HC. The association of microalbuminuria and mortality in non-insulin-dependent diabetes mellitus. Arch Intern Med 1997; 157:1413-1418.
3. Selvetti A, Mattei P, Sudano I. Renal protection and antihypertensive drugs. Drugs 1999; 57:665-693.
4. Lacourciere Y, Nadeau A, Poirier L, Tonerede G: Captopril or conventional therapy in hypertensive type 2 diabetics: three year analysis. Hypertension 1993; 21:786-794.
5. Cooper ME. Renal protection and angiotensin converting enzyme inhibition in microalbuminuric type I and type II diabetic patients. J Hypertens 1996; 14 (suppl G) :11-14.
6. Gansevoort RT, De Zeeuw D, Shahinfar S, Redfield A, De Jong PE. Effects of the angiotensin II antagonist losartan in hypertensive patients with renal disease. J Hypertens 1994;12:37-42.
7. Nielsen S, Dollerup J, Nielsen B, Jensen HAE, Mogensen CE. Losartan reduces albuminuria in patients with essential hypertension: An enalapril controlled 3 months study. Nephrol Dial Transplant 1997;12 (suppl 2):19-23.
8. Lacourciere Y, Belanger A, Godin C, et all Long-term comparison of losartan and enalapril on kidney function in hypertensive type 2 diabetics with early nephropaty. Kidney Int 2000;58:762-769.
9. Lazano JV, Llisterri JL, Aznar J, Redon J. Losartan reduces microalbuminuria in hypertensive microalbuminuric type 2 diabetics. Nephrol Dial Tranplant 2001; 16 (suppl 1): 85-89.
10. Parving HH, Lehnart H, Brochnes The effect of irbesartan on the development of diabetic nephropathy in patients with type 2 diabetes. N Eng J Med 2001 ;345( 12)870-8.
11. Viberti G, Wheeldon NM; Microalbuminuria Reduction with VALsartan (MARVAL) Study Investigators. Microalbuminuria reduction with valsartan in patients with type 2 diabetes mellitus: a blood pressure independent
effect. Circulation 2002;106(6):672-8.
12. Muirhead N, Feagan BF, Mahon J et al. The effects of valsartan and captopril on reducing microalbuminuria in patients with type 2 diabetes: a placebo-controlled trial.
Curr therapeutic Res 2000;60::650-60.
13. Lacourciere Y, Brunner A, Irwin R et al. The losartan cough study group. Effects of the modulators of the renin-angiotensin-aldosterone system on cough. J Hypertens 1994; 12:1387-1397.

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