Triple Blockade of the Renin Angiotensin Aldosterone System in Diabetic (Type 1&2) Proteinuric Patients
Status: | Terminated |
---|---|
Conditions: | Diabetic Neuropathy, Endocrine, Nephrology, Diabetes |
Therapuetic Areas: | Endocrinology, Nephrology / Urology |
Healthy: | No |
Age Range: | 18 - Any |
Updated: | 10/14/2017 |
Start Date: | August 2009 |
End Date: | September 2012 |
Study of Triple Blockade of the Renin Angiotensin Aldosterone System (RAAS) in Diabetic (Type 1&2) Proteinuric Patients With (ACE-, ARB, DRI)
Study Hypothesis:
Reduction in albuminuria has been shown to decrease progression of diabetic
nephropathy. In diabetic nephropathy patients treated with maximal
antihypertensive doses with dual RAAS blockade (total daily dose valsartan 320
mg and either enalapril 40 mg or benazepril 40 mg daily, or losartan 100mg), persistent
albuminuria reflects further additional RAAS activation. Microvascular renal
disease due to increased RAAS activation may be more effectively treated with
triple blockade by the addition of a direct renin inhibitor (DRI) Aliskiren.
Reduction in albuminuria has been shown to decrease progression of diabetic
nephropathy. In diabetic nephropathy patients treated with maximal
antihypertensive doses with dual RAAS blockade (total daily dose valsartan 320
mg and either enalapril 40 mg or benazepril 40 mg daily, or losartan 100mg), persistent
albuminuria reflects further additional RAAS activation. Microvascular renal
disease due to increased RAAS activation may be more effectively treated with
triple blockade by the addition of a direct renin inhibitor (DRI) Aliskiren.
Inclusion Criteria:
- Macroalbuminuria > 300mg/g
- Microalbuminuria 30-300mg/g
- Stable on max dose of an ACE-I or ARB (Can also be titrated to max dosage of ACE-I and
ARB and stable on those doses for at least 2 weeks)
- Blood pressure <130/80 mm Hg at time of enrollment
- Diabetic either Type 1 or 2
Exclusion Criteria:
- GFR <60 m/min
- Potassium > 5mg/dl at time of enrollment
- Pregnant
- History of Angioedema
- ACE-I cough
- Allergic to ARB, ACE-I, DRI
- A1C > 9%
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