Main Organiser

Julius Centre University of Malaya

Co-organiser

Department of Social and Preventive Medicine, Faculty of Medicine, University of Malay

Supported by

University of Malaya

EFFECT OF ANGIOTENSIN-CONVERTING ENZYME INHIBITORS AND/OR ANGIOTENSIN RECEPTOR BLOCKERS ON THE PREVENTION OF DEATH IN PATIENTS WITH TYPE 2 DIABETES AND UNDETERMINED NEPHROPATHY

Author

Mongkolsomlit Sirima

Institution

Thammasat University, Chiang Mai University

Abstract

Objectives : To compare renal and other causes of death between those treated and not treated with ACEIs/ARBs in type 2 diabetes patients who are non-nephropathic, nephropathic and have an undetermined nephropathy status.

Methods: 7,946 type 2 diabetes patients who registered with the Thailand Diabetes Registry Project (TDRP) in 2003 were followed-up prospectively for 5 years until January 25, 2008. Living statuses were retrieved from the database of each study site and causes of death were retrieved from the death certificates from the Bureau of Registration Administration of Thailand.

Results: There were 716 type 2 diabetic patients that died within 5 years of registration in the TPDR from all causes of death. Of these cases, 66 died from renal causes. After controlling for the propensity score, the competing risk analysis showed that treatment with ACEIs/ARBs was not significantly associated with prevention of death from renal or other causes in type 2 diabetes patients with an undetermined nephropathy status (HR=0.83, 95% CI: 0.33-2.09, p-value=0.688 for renal causes; HR=1.26, 95% CI: 0.97-1.63, p- value=0.085 for other causes).

Conclusion: Treatment with ACEIs or ARBs is not necessary for everyone, especially in type 2 diabetes patients with an undetermined nephropathy status.