Blood Pressure Medicine Reverses Kidney Failure

The largest and longest study ever conducted to learn about the effects of a medication on people with nephropathy recently concluded. It found that a drug called Captopril can slow or halt the progression of nephropathy (kidney disease) in people with diabetes who show signs of this complication. Captopril is an ACE inhibitor, a medication used to treat hypertension.

The study involved 409 people with type I diabetes who showed signs of kidney disease, defined as a 24-hour proteinuria level greater than 500 mg. They were followed from 30 clinical centers around the United States and Canada for an average of 3 years. Half the patients were given 25 mg of Capto-pril three times daily and half were given identical placebo tablets instead.

The results of the study, as compared with the patients on the placebo, indicate a 50% reduction in the combined risk of mortality or progression to end-stage renal disease, which requires either dialysis or kidney transplantation. Although it seems likely that this treatment would work on people with type 2 diabetes, the researchers caution that there is a need for further study to confirm this.

An economic analysis of treatment with Captopril concluded that it could save as much as $2,900 per person per year. Additionally, the analysis estimated the potential savings due to reductions in end-stage renal disease expenditures at $260 million per year.

Until now there has been no therapy that can improve a patient’s condition once he or she develops diabetic nephropathy. Therefore, any treatment which can prolong survival or delay the need for dialysis or transplantation is an important advance for patients who develop nephropathy.