(精选)brenner may 19教学课件.pptVIP

RENAAL Altering the Course of Renal Disease in Hypertensive Patients with Type 2 Diabetes and Nephropathy with the AII Antagonist Losartan;Angiotensin II Drives Pathology in Hypertension ;Clinical Endpoint Data for ESRD in Type 2 Diabetes with ACE Inhibitors Are Lacking;Controlling the Course of Renal Disease with Losartan;Effect of Losartan on Microalbuminuria;RENAALReduction of Endpoints in NIDDM with the AII Antagonist Losartan;RENAAL Primary Hypothesis;Losartan compared to placebo (alone or in combination with conventional antihypertensive therapy*) in patients with Type 2 diabetes and nephropathy will Increase the time to first event and decrease the incidence of cardiovascular morbidity/mortality Reduce proteinuria Decrease the rate of progression of renal disease;;RENAAL Primary Composite Endpoint and Components;ESRD;RENAALPrimary Composite EndpointDoubling of sCr / ESRD / Death;RENAALTime to ESRD from Doubling of sCr; Baseline Year 1 Year 2 Study End Systolic/diastolic Losartan (+CTx) 152/82 146/78 143/77 140/74 Placebo (+CTx) 153/82 150/80 144/77 142/74 Mean arterial pressure Losartan (+CTx) 105.5 100.9 99.1 95.9 Placebo (+CTx) 106.0 103.1 99.7 96.8 Pulse pressure Losartan (+CTx) 69.4 67.8 66.2 66.7 Placebo (+CTx) 70.8 69.8 67.1 67.4;;RENAALDose of Losartan ;RENAALConcurrent Antihypertensive Medications; RENAAL Secondary Composite Endpointand Components;RENAALFirst Hospitalization for Heart Failure;0;RENAALRate of Progression of Renal Disease (median 1/sCr slope);RENAALMost Common Clinical and Laboratory Adverse Experiences Leading to Discontinuation of Study Therapy;Public Health and Economic Implications of RENAAL (US);Public Health and Economic Implications of RENAAL (EU);RENAAL Summary (I);RENAAL Summary (II) ;RENAALConclusions;RENAAL results show that losartan + CTx Provided excellent tolerability Provided proven renal protection and cardioprotective benefit 28% risk reduction in ESRD 32% risk reduction in in