Abstract

BLANCO-UHIENHAUT, Mariana  and  SAENZ-CAMPOS, Desirée. Evaluación clínica de la nefroprotección de los bloqueadores de anglotensina II (ARA II). Acta méd. costarric [online]. 2003, vol.45, n.2, pp.45-49. ISSN 0001-6002.

The angiotensin receptor antagonists (ARA II) represent the latest group of drugs in the treatment of hypertension and an alternative against angiotensin-converting-enzyme (ACE) inhibitors in patients with type 2 diabetes. Because its relevance and polemic role, we reviewed severas clinical trials to identify any renoprotective effect in patients with type 2 diabetes with or without hypertension. We analized the results of REENAL, IDNT, IRMA II and MARVAL trials. In conclusion, the renoprotective effect of the ARA II drugs is related especifically to changes in nephropathy morbility and to a delay in the progression of nephropathy in diabetic patients. We do not have data to generalize these properties to all the drugs of this group. Nevertheless, they might be indicated as an alternative to ACE inhibitors when side effects are present. lt is not reasonable to expect the same renoprotective effect of ACE inhibitors because none of the ARA II drugs has diminished the mortality in patients with nephropathy due to type 2 diabetes and hypertension.

Keywords : Diabetes Mellitus tipo 2; hipertensión arterial; inhibidores de la enzima convertidora de angiotensina (IECAs); antagonistas del receptor de angiotensina Il (ARA II); nefropatía diabética; nefroprotección.