Trial reportDiabetologia1996
Captopril reduces the risk of nephropathy in IDDM patients with microalbuminuria. The Microalbuminuria Captopril Study Group.
Trial report in Diabetologia, 1996. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 31 papers, 4 of them syntheses that pooled it.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
31 citing papers in PubMed, 4 syntheses or guidelines pooled it, 164 citations in OpenAlex.
- Angiotensin-converting-enzyme inhibitors and angiotensin receptor blockers for preventing the progression of diabetic kidney disease.The Cochrane database of systematic reviews · 2024Pooled it
- Guideline
- Prevention of chronic kidney disease and subsequent effect on mortality: a systematic review and meta-analysis.PloS one · 2013Pooled it
- Evidence-based practice guideline for the treatment of CKD.Clinical and experimental nephrology · 2009Guideline
- Effects of low-dose losartan treatment on persistent microalbuminuria in normotensive type 1 diabetic subjects.Journal of endocrinological investigation · 2001Trial
- Mediation analysis for estimating cardioprotection of longitudinal RAS inhibition beyond lowering blood pressure and albuminuria in type 1 diabetes.Annals of epidemiology · 2020Article
- Rapid increase in the incidence of end-stage renal disease in patients with type 1 diabetes having HbA1c 10% or higher for 15 years.Clinical pediatric endocrinology : case reports and clinical investigations : official journal of the Japanese Society for Pediatric Endocrinology · 2019Article
- Renin-Angiotensin-Aldosterone System Blockade in Diabetic Nephropathy. Present Evidences.Journal of clinical medicine · 2015Review
- Management of diabetic renal disease.Annals of translational medicine · 2015Review
- Prevalence and Management of Diabetic Nephropathy in Western Countries.Kidney diseases (Basel, Switzerland) · 2015Review
- Comprehensive approach to diabetic nephropathy.Kidney research and clinical practice · 2014Review
- Diabetic nephropathy; principles of diagnosis and treatment of diabetic kidney disease.Journal of nephropharmacology · 2014Review
- Diabetic nephropathy - complications and treatment.International journal of nephrology and renovascular disease · 2014Review
- Losartan affects glomerular AKT and mTOR phosphorylation in an experimental model of type 1 diabetic nephropathy.The journal of histochemistry and cytochemistry : official journal of the Histochemistry Society · 2013Article
- Hypertension in chronic kidney disease: navigating the evidence.International journal of hypertension · 2011Article
- Renin-angiotensin-aldosterone system blockade for cardiovascular diseases: current status.British journal of pharmacology · 2010Review
- Anemia and hypertension are risk factors for both renal prognosis and survival in patients with diabetes mellitus.Clinical and experimental nephrology · 2009Article
- Long-term prevention of diabetic nephropathy: an audit.Diabetologia · 2008Article
- Divergences in antihypertensive therapy in special situations in nephrology.Sao Paulo medical journal = Revista paulista de medicina · 2008Article
- Renal protection: are all antihypertensive drugs comparable?Current hypertension reports · 2007Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
0 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
In insulin-dependent diabetes mellitus (IDDM), microalbuminuria predicts renal and cardiovascular disease. We report a combined analysis of 235 normotensive IDDM patients with microalbuminuria who participated in two 24-month double-blind, randomised, placebo-controlled trials to assess the effects of captopril 50 mg twice daily on the progression to overt clinical albuminuria. Of the 225 patients who were evaluable on an intent to treat basis, 25 of 114 placebo-treated patients (21.9%) and 8 or 111 captopril-treated patients (7.2%) progressed to persistent clinical albuminuria. The risk of progression over 24 months was significantly reduced by captopril (p = 0.004) with a risk reduction of 69.2% (95% confidence interval (CI):31.7 to 86.1%). This degree of risk reduction remained at the same level (62.9% [16.1-83.6%], p = 0.017) after adjustment for differences in time-varying mean arterial blood pressure. Albumin excretion rate increased by an average of 14.2% [3.1-26.5%] per year in the placebo-treated group compared with a reduction of 9.6% [-18.6-0.4%] per year in the captopril-treated group (p = 0.002). The rate of fall of creatinine clearance tended to be faster in the placebo-treated group than in the captopril-treated group (-6.4 [-10.2- -2.5] vs -1.4 [-5.3-2.6] ml.min-1.1.73m-2, p = 0.07). Baseline albumin excretion rate (p < 0.0001) and glycated haemoglobin (p = 0.03) were independent predictors of progression to clinical albuminuria and changes in mean arterial blood pressure (p = 0.02) and serum cholesterol level (p = 0.003) were significantly associated with percentage changes in albumin excretion rate. Captopril reduces the risk of progression to overt nephropathy in IDDM patients with microalbuminuria, an effect partly independent of its blood pressure-lowering effects.
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