The Effect of Losartan on Microalbuminuria in the Treatment of Early Stage of Diabetic Nephropathy Independent of Blood Pressure

Objective To investigate whether the effect of angiotensin Ⅱ receptor antagonist losartan on microalbuminuria in patients of diabetic nephropathy independent of blood pressure . Methods Fouty-three patients with early stage diabetic nephropathy were randomly divided into two groups, 23 in treatment group(losartan 50 mg/d) and 20 in control group. Blood pressure in all patients were in normal range. Plasma glucoses were controlled to the level of fasting blood glucose (FBG) ≤7 mmol/L, and postprandial 2 h blood glucose (P2hBG) ≤10 mmol/L. The urinary albumin excretion rate (UAER) of all patients was between 20 to 200 μg/min . The control group patients were administered with placebo. Fast blood glucose (FBG), post 2 h blood sugar ( P2hBG), HbA1c and urine albumin excretion rate (UAER) were examined before and 12 weeks after the treatment. Results After 12 weeks, the mean microalbuminuria level in treatment group declined significantly from 119±14 μg/min to 76±11 μg/min (P0.05), compared to that of control group 125±13 μg/min (P0.05). However, no changes in BP was found before and after treatment. Conclusion Angiotensin Ⅱ receptor antagonist decrease microalbuminuria and postpone the deterioration of diabetic nephropathy in type2 diabetes patients independent of blood pressure.