Blood-pressure drugs seem to help prevent kidney disease.
THE QUESTION An increase of albumin in the urine of people with Type 2 diabetes is considered an early sign of kidney disease. Might blood-pressure drugs -- such as ACE inhibitors and calcium channel blockers -- help prevent this condition, known as microalbuminuria?
THIS STUDY involved 1,204 adults with Type 2 diabetes and high blood pressure but normal levels of urinary albumin. They were randomly assigned to one of four treatments: an ACE inhibitor (trandolapril), a calcium channel blocker (verapamil), a combination of the two or a placebo. After 3 1/2 years, microalbuminuria had developed in 6 percent of those who had taken the combination or the ACE inhibitor alone, compared with 12 percent of those who had taken channel blockers and 10 percent of the placebo group.
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WHO MAY BE AFFECTED BY THESE FINDINGS? People with Type 2 diabetes, which affects more than 170 million people worldwide. An estimated one-third of them will develop kidney disease.
CAVEATS Twelve participants died during the study, including five from cardiovascular disease (one was taking the ACE inhibitor; one, the channel blocker; and three, the placebo). The study was funded in part by Abbott, which markets the drugs used in the study.
BOTTOM LINE People with Type 2 diabetes may want to talk with their doctor about taking an ACE inhibitor or a combination ACE inhibitor/channel blocker.
FIND THIS STUDY Nov. 4 issue of the New England Journal of Medicine; abstract available online at www.nejm.org.
LEARN MORE ABOUT diabetic kidney disease at www.kidney.organd www.diabetes.org.
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THE QUESTION For adults with leukemia, transplanting stem cells obtained from a donor's blood has become more common than using stem cells from a donor's bone marrow. In both instances, the cells replace cancerous bone marrow, but using cells from blood allows donors to avoid hospitalization, anesthesia and surgery. Is this treatment also preferable for children with leukemia?