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Dual angiotensin inhibition for diabetic nephropathy is harmful

KEY POINT

 

Among patients with diabetic nephropathy, the combination of an ACE inhibitor and an angiotensin receptor blocker (ARB) did not decrease morbidity or progression to end-stage renal disease as compared with an ARB alone. However, combination therapy was associated with a higher risk for serious adverse events including hyperkalemia and acute kidney injury.

SOURCES

 

Fried L et al. Combined angiotensin inhibition for the treatment of diabetic nephropathy. N Engl J Med. 2013;369:1892–1903. http://www.nejm.org/doi/full/10.1056/NEJMoa1303154

De Zeeuw D. The end of dual therapy with renin-angiotensin-aldosterone system blockade [editorial]? N Engl J Med. 2013;369:1960–1962. http://www.nejm.org/doi/full/10.1056/NEJMe1312286