Serum potassium in dual renin-angiotensin-aldosterone system blockade

摘要

Treatment with angiotensin-converting enzyme inhibitors(ACEIs) or angiotensin receptor blockers (ARBs)slows the progression of proteinuric diabetic kidneydisease (1–3).However, the risk of progression remainshigh despite these medications. In the Reduction ofEndpoints in NIDDM with the Angiotensin II AntagonistLosartan trial and the Irbesartan Diabetic NephropathyTrial, the treatment-induced decrease inalbuminuria correlated with overall benefit in termsof risk of CKD progression, and individuals with residualalbuminuria despite ARB treatment were athigher risk for progression (1,3).