Comparison of Efficacy of Angiotensin-Converting Enzyme Inhibitors (ACEIs) and Angiotensin Receptor Blockers (ARBs) in Delaying Diabetic Nephropathy

Fraz Tahir; Syeda Arsheen Rizvi; Faisal Naveed Akhtar

doi:10.51253/pafmj.v75i2.9146

Authors

Fraz Tahir Department of Medicine, Pakistan Navy Ship Hafeez Hospital, Islamabad Pakistan
Syeda Arsheen Rizvi Department of Medicine, Pakistan Navy Ship Hafeez Hospital, Islamabad Pakistan
Faisal Naveed Akhtar Department of Medicine, Pakistan Navy Ship Hafeez Hospital, Islamabad Pakistan

DOI:

https://doi.org/10.51253/pafmj.v75i2.9146

Keywords:

Angiotensin-Converting Enzyme Inhibitors (ACEIs), Albumin-creatinine ratio, Angiotensin Receptor Blockers (ARBs), Diabetic nephropathy

Abstract

Objective: To compare the effect of angiotensin‐converting enzyme inhibitors and angiotensin receptor blockers on renal damage in terms of change in mean albumin-to-creatinine ratio.

Study Design: Cross-sectional study.

Study Place and Duration: PNS Hafeez, Islamabad, Pakistan, from Feb to Jul 2021.

Methodology: We included 1300 patients using non-probability purposive sampling, divided into two groups. Patients aged between 30-60 years, suffering from Type 2 Diabetes Mellitus with detectable microalbuminuria having Urine Albumin to Creatinine Ratio >30mg/g, before starting the medication with either angiotensin‐converting enzyme inhibitors or ARB, were considered for inclusion. Patients with ischemic heart disease, vasculitis, glomerulonephritis, protein-losing enteropathy, liver disease, malignancy, urinary tract infection, and any contraindication of ACE inhibitor and ARBs were excluded.

Results: In Group A, the duration of disease was 9.22±3.45 years, and in Group B, it was 9.11±3.58 years. The delay in nephropathy progression between the two groups was established by measuring the mean change in ACR after 3 months in both groups. It was established that angiotensin‐converting enzyme inhibitors (mean change 0.93±0.16 mg/g) was adequately efficient in delaying the albuminuria over three months of treatment than ARBS (mean change 1.097±0.26 mg/g) (p˂ .001).

Conclusion: In comparison, angiotensin‐converting enzyme inhibitors were more adequate than angiotensin receptor blockers in creating change in mean albumin-to-creatinine ratio.

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Author Biography

Fraz Tahir, Department of Medicine, Pakistan Navy Ship Hafeez Hospital, Islamabad Pakistan

Major Fraz Tahir

Graded Medical Specialist

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