The Preliminary Observation On Effect Of Cilazapril Combined With Irbesartan In Treating Early Diabetic Nephropathy

Background and ObjectiveDiabetic nephropathy (DN) is a common chronic complication of diabetes mellitus and one of the main reasons cause death, which hasn't been well treated .Untreated early DN patients progress quickly into end stage renal disease .So it's very important to treat the early DN in improving their quality of life and the survival time .Many researches demonstrate that angiotensin converting enzyme inhibitors(ACEI)/angiotensin receptor II antagonists (ARB) exhibit renoprotective effects by inhibiting overactive renin-angiotensin-aldosterone system in kidney and combination makes better .This study aims to investigate the effect of monotherapy or combination of cilazapril and irbesartan in treating early DN.Methods12 DN patients of early stage with normal blood pressure were divided into three groups: cilazapril (2. 5mg, qd), irbesartan (150mg, qd) or the combination of these two drugs for two weeks. The changes of blood pressure, transient ratio between urine albumin and creatinine (microalbuminuria), serum potassium, serum creatinine(SCr),blood urea nitrogen(BUN), fasting blood glucose(FBG), triglyceride(TG), low density lipoprotein cholesterol (LDL-C) were observed before and after treatment.ResultsAll of cilazapril, irbesartan or the combination of these two reduced blood pressure and the transient ratio between urine albumin and creatinine after the treatment .The reduction in the ratio was greater in the combination therapy than any monotherapies . SCr, FBG, TG, LDL-C were also reduced after general treatment.ConclusionsCombination of cilazapril and irbesartan in patients with early DN and normal blood pressure produces a better anti-proteinuric, DN-progress-retardation effect than either of the monotherapies . Adverse effects don't increase accordingly, especially serious hypotention.