Slide 18 of 30
Notes:
Multiple studies have shown that ACE inhibitors can prevent the progression of incipient Diabetic nephropathy to overt diabetic nephropathy. These studies have been carried out in Type 1 and Type 2 diabetes. Mechanism appears to be a combination of effects on blood pressure and direct effects on the kidney itself. This is supported by the fact that studies in normotensive patients have shown similar results.
Mechanisms of ACE inhibitor effect
Decrease in intra-glomerular pressure
reduce membrane permeability
restore loss of anionic charge selectivity
antiproteinuric effect may be important because glycated albumin may be toxic to glomerular cells
