Abstract
The available evidence on renal protection in type 2 diabetes mellitus favors the administration of an angiotensin receptor blocker (ARB) more than that of an angiotensin converting enzyme inhibitor (ACEi). This evidence is based on recent studies showing that losartan and irbesartan can prevent the development of overt diabetic nephropathy in microalbuminuric type 2 diabetic patients as well as slow the velocity of progression to end-stage renal disease in patients with overt type 2 diabetic nephropathy. These studies do not deny the possibility that ACEi are equally effective, but studies of an adequate magnitude are lacking. These findings on ARB administration do not preclude the importance of strict control of blood pressure and proteinuria and/or albuminuria to avoid or retard renal damage in type 2 diabetic patients.
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