Combination therapy with small-dose benazepril plus valsartan for diabetic nephropathy in early stage in elderly patients

Objective To study prospectively the efficacy and rationality of treating early diabetic nephropathy in elderly patients using combination therapy of valsartan and benazepril in half dosage. Methods One hundred and twenty elderly cases of type 2 diabetes with early diabetic nephropathy were randomly divided into three groups. Forty patients were given benazepril 10 mg/d or valsartan 80 mg/d respectively. Another 40 cases were treated with benazepril 5 mg/d combined with valsartan 80 mg/d . Before and after 24 weeks' therapy, the mean arterial pressure (MAP), urinary albumin excretion rate (UAER), endogenous creatinine clearance (CCr), serum creatinine (SCr), blood urea nitrogen (BUN), fasting blood glucose (FBG), 2 h postcibum blood glucose ( 2 h PBG), hemoglobin A1c (HbA1c), serum potassium and blood lipid were determined. Results Before and after therapy, there were no significant differences in FBG, 2 h PBG, HbA1c, SCr, BUN, CCr, MAP, TG, TC, HDL-C, LDL-C and serum potassium among the three groups. UAER in all the groups showed significant decreases after treatments (P0.01), and decreased mostly in the combinative treatment group (P0.05). But there were no significant differences between valsartan and benazepril group (P0.05). Conclusions It is an effective and reasonable way to treat early diabetic nephropathy in elderly patients with combination therapy with valsartan plus benazepril. The protective effects on the kidney is independent from the influence on the blood pressure.