Adequate vascular repair is relevant to improving renal perfusion and function following vasodilators in normoalbuminuric type 2 diabetic nephropathy.

摘要

To the Editor: We read with great interest the article from Ritt et al entitled "Renal Vascular Endothelial Function in Hyperten- sive Patients With Type 2 Diabetes Mellitus," in which improved endothelial function of the renal vasculature was substantiated after telmisartan or ramipril therapy in 50 normoalbuminuric patients with type 2 diabetes mellitus. Such intrarenal hemodynamic improvement is supported by our recent study showing adequate vascular repair by both angiogenic (namely vascular endothelial growth factor [VEGF], angiopoietin 1, and VEGF receptor 1 [encoded by FLT1]) and antiangiogenic factors (namely angiopoietin 2 and VEGF receptor 2 [encoded by KDR]) in normoalbuminuric patients with type 2 diabetic nephropathy compared with controls (Futrakul et al, unpublished data). The improved renal hemodynamics and kidney function in this study also concur with our previous publication.