Monotherapy or combination therapy with fosinopril and losartan in 90 patients with early diabetic nephropathy

AIM:To study the effects of combination of fosinopril and losartan in treating early diabetic nephropathy. METHODS:Ninty patients of type 2 diabetes mellitus (DM) with early diabetic nephropathy were randomly divided into three groups. All patients were kept on previous management of DM. The patients in the fosinopril group were treated with fosinopril 10 mg daily, the losartan group with losartan (50 mg) daily and the combination group with fosinopril (10 mg) and losartan 50 mg daily. Period of treatment for all groups was 12 wk. Urinary albumin excretion rate (UAER), glycohemoglobin A_(1c) (HbA_(1c)), blood urea nitrogen(BUN), serum creatinine (Scr) , uratic acid (UA), the mean arterial pressure (MAP) were observed before and after the treatment. RESULTS: UAER after treatment of three groups were all decreased (P0.01). Interestingly, reduction of UAER was remarkable in the combination group[(76±(39) mg)·24 h~(-1),vs (55±36),(46±42) mg·(24 h~(-1)),(P(0.05]).) HbA_(1c) after treatment in the fosinopril group and the combination group were significantly (decreased)(P0.05). While, MAP of three groups were also decreased (P0.01). No significant differences in blood pressure were shown among three groups after the treatment. CONCLUSION: Fosinopril and losantan can lower albuminurea in the patients with early diabetic nephropathy. Furthermore there is a synergism with combination of the two drugs. Besides independent from anti-hypertension effect,renin-angiotensin system drugs also have the renal protective effect.