Use Of Ace Inhibitors Or ARA II As Nephroprotection In Normotensive Normoalbuminuria Diabetic Patients

The prevalence of diabetes mellitus (DM) is increasing throughout the world quickly driven by the increase of obesity, hyperglycemia due to the resistance to insulin, lipid accumulation renal, inflammation and activation of the renin-angiotensin system (RAAS), which contributes to the development of microvascular and macrovascular complications, as in the pathogenesis of diabetic nephropathy (ND).The adipose tissue is a key organ in the resistance to the insulin; the adipocytes are the origin of an inflammatory process that is characterized by the infiltration of macrophages and increase of inflammatory cytokines, which leads to the initiation of the diabetic nephropathy. The RAAS is closely associated with the generation of reactive oxygen species (ROS) in the diabetic nephropathy; whereas hyperglycemia prolonged produces mitochondrial ROS, which leads to the microvascular complications of diabetes. Objective: of this retrospective study is to assess the effect of IECAS or ARA II in patients with DMII normoalbuminuria, normotensive as renoprotective and to prevent future complications irreversible, as its evolution in the diabetic nephropathy and hypertension. Methods and Analysis: This study was conducted with 116 patients within the ages of 20 70 years of age having DM II from 2002 until the present normotensive and normoalbuminuria of which 64 are men and 52 women with multiple risk factors such as obesity, overweight diseases history family coronary, smoking and sedentary mostly, 91 patients receive Lisinopril (ACEI) 5mg and 25 patients losartan (ARAII) 25mg per night continuously from the time DM II is detected. Results: The prevention of microalbuminuria, despite its limitations, is clinically important in the attention of our cases as a noble proposal, practical, achievable, of low cost and with extraordinary results in primary prevention in the present and future of the patients with DM II. In addition because the IECAS AND ARAII are used when the patient presents an irreversible damage with an uncertain future. Conclusions: I share my experience of more than 14 years using low doses of lisinopril 5mg or Losartan 25mg ingested by the nights continuously in patients present with DMII normoaalbuminuric of several years of evolution of their disease without hypertension. Possibly a study or investigation with many defects but with undeniable beneficial, even more in our country Ecuador that has epidemiological characteristics similar to many countries of the world, and where the dialysis units are not supplied to give palliative treatment for diabetic patients with CRF, causing exorbitant costs of millions of dollars in this chronic disease that is not transmittable. I would venture to say that, Doctors should begin to use in all diabetic cases the drugs listed above for a long time and continuous monitoring of the patient..