Preventing Kidney Disease

(Ivanhoe Newswire) -- The current standard for treating high blood pressure in patients with kidney disease may not be the best choice. A new study reveals lowering blood pressure is more important than the specific drug class used to do so.

Two classes of drugs are currently used as the first-line of treatment to lower blood pressure in kidney disease patients -- angiotensin-converting-enzyme (ACE) inhibitors and angiotensin-II receptor blockers (ARB). National and international guidelines endorse the use of the two drug classes and doctors have assumed the drugs have a specific way of protecting the kidney besides their ability to lower blood pressure.

Now, researchers from University College in London find ACE inhibitors and ARBs are no better than other drugs used to lower blood pressure in preventing diabetic kidney disease. Researchers also indicate that it is unclear if the drugs are more effective in non-diabetic kidney disease.

"There seems to be little justification for ACE inhibitors or ARBs to be the first-line choices for renoprotection in diabetes on the basis of efficacy, and residual uncertainty still exists about the inherent value of these drugs in other renal disorders," study authors say. "In view of the present analysis, treatment decisions for hypertension in renal diseases should be based on the blood-pressure-lowering effects, comparative tolerability, and cost of antihypertensive treatment."

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SOURCE: The Lancet, 2005;366:2026-33