EFFECTS OF BENAZEPRIL AND NICARDIPINE ON MICROALBUMINURIA IN NORMOTENSIVE AND HYPERTENSIVE PATIENTS WITH DIABETES

Diabetic nephropathy is the most frequent cause of chronic renal failu re. The onset of microalbuminuria in patients with diabetes mellitus, which seems to be related to blood pressure and the control of glycemi a, is predictive of the development of true proteinuria. This multicen ter, single-blind, randomized study examined the effects of benazepril and nicardipine on overnight microalbuminuria in 57 normotensive and 46 hypertensive diabetic patients. At the end of a 3-month placebo run -in period, the patients were stratified on the basis of the presence or absence of arterial hypertension and, within each stratum, randomiz ed to receive one daily tablet of 10 mg benazepril or one tablet of 20 mg nicardipine twice daily for 6 months. Renal hemodynamics was inves tigated in 25 patients. Both drugs decreased overnight microalbuminuri a throughout the study period, but benazepril was more effective than nicardipine (P=0.025); in the patients with hypertension, both drugs l ed to a similar marked reduction in systolic and diastolic blood press ure. This study shows that benazepril was more effective than nicardip ine in reducing overnight microalbuminuria in patients with diabetes m ellitus, independently of their antihypertensive properties.