Nefropatía diabética
Páginas: 2 (378 palabras)
Publicado: 3 de marzo de 2011
What are the effects of treatments in persons with type 1 diabetes and early nephropathy?
BENEFICIAL
Angiotensin-Converting Enzyme Inhibitors (Progression To Late Nephropathy).
One systematicreview found that, compared with placebo or controls, angiotensin-converting enzyme (ACE) inhibitors (captopril, lisinopril, enalapril, perindopril, and ramipril) reduced progression to macroalbuminuriaand increased regression to normoalbuminuria in normotensive persons with type 1 diabetes and microalbuminuria. We found no randomized controlled trials (RCTs) comparing angiotensin-II receptorantagonists and ACE inhibitors in persons with type 1 diabetes and early nephropathy.
Glycemic Control (Progression to Late Nephropathy).
One systematic review found that, compared with conventionalcontrol, intensive glycemic control reduced progression of nephropathy in persons with type 1 diabetes and either normal albumin excretion or microalbuminuria. The review showed no significant differencebetween intensive glycemic control and conventional control in the incidence of severe hypoglycemia. The review showed a higher incidence of diabetic keto-acidosis in persons treated with continuoussubcutaneous insulin infusion compared with conventional multiple injection treatment.
UNKNOWN EFFECTIVENESS
Angiotensin-II Receptor Antagonists.
We found no RCTs comparing the effects ofangiotensin-II receptor antagonists with placebo on outcomes of all-cause mortality, incidence of end-stage renal disease, or incidence of cardiovascular events (e.g., stroke, heart failure, myocardialinfarction) in persons with type 1 diabetes and early nephropathy. Long-term placebo-controlled RCTs would not be ethical because of the established benefits of ACE inhibitors and the similarity between thesetwo drug classes. We found no RCTs comparing angiotensin-II receptor antagonists with ACE inhibitors in persons with type 1 diabetes and early nephropathy.
Protein Restriction.
We found no RCTs...
BENEFICIAL
Angiotensin-Converting Enzyme Inhibitors (Progression To Late Nephropathy).
One systematicreview found that, compared with placebo or controls, angiotensin-converting enzyme (ACE) inhibitors (captopril, lisinopril, enalapril, perindopril, and ramipril) reduced progression to macroalbuminuriaand increased regression to normoalbuminuria in normotensive persons with type 1 diabetes and microalbuminuria. We found no randomized controlled trials (RCTs) comparing angiotensin-II receptorantagonists and ACE inhibitors in persons with type 1 diabetes and early nephropathy.
Glycemic Control (Progression to Late Nephropathy).
One systematic review found that, compared with conventionalcontrol, intensive glycemic control reduced progression of nephropathy in persons with type 1 diabetes and either normal albumin excretion or microalbuminuria. The review showed no significant differencebetween intensive glycemic control and conventional control in the incidence of severe hypoglycemia. The review showed a higher incidence of diabetic keto-acidosis in persons treated with continuoussubcutaneous insulin infusion compared with conventional multiple injection treatment.
UNKNOWN EFFECTIVENESS
Angiotensin-II Receptor Antagonists.
We found no RCTs comparing the effects ofangiotensin-II receptor antagonists with placebo on outcomes of all-cause mortality, incidence of end-stage renal disease, or incidence of cardiovascular events (e.g., stroke, heart failure, myocardialinfarction) in persons with type 1 diabetes and early nephropathy. Long-term placebo-controlled RCTs would not be ethical because of the established benefits of ACE inhibitors and the similarity between thesetwo drug classes. We found no RCTs comparing angiotensin-II receptor antagonists with ACE inhibitors in persons with type 1 diabetes and early nephropathy.
Protein Restriction.
We found no RCTs...
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