THERAPEUTIC PROGRESS .3. DIABETIC NEPHROPATHY

Diabetic nephropathy is a common cause of end stage renal failure. Pat ients ultimately require dialysis or transplantation and endure a poor quality of life in association with increased mortality. Due to the q uantitative significance of this problem there is also a considerable financial burden. It has been generally accepted that one nephropathy is established it is irreversible although aggressive anti-hypertensiv e treatment can delay its progression. More recently there have been n umerous reports proposing a specific renal protective role of certain drugs. In this article we review the current literature on the use of angiotensin converting enzyme inhibitors in diabetic nephropathy. Ther e is strong evidence that the use of ACE inhibitors in diabetic nephro pathy (in the presence or absence of hypertension) slows the progressi on of deterioration in renal function and may even arrest its progress ion if detected at the microproteinuric stage.