规范ARB治疗共识到临床应用.ppt

INNOVATION recruited 527 patients with type 2 diabetes and evidence of incipient nephropathy.1,2 Hypertension was not an inclusion criterion. Makino H, et al. Prevention of transition from incipient to overt nephropathy with telmisartan in patients with type 2 diabetes. Diabetes Care 2007; in press. Makino H, et al. The telmisartan renoprotective study from incipient nephropathy to overt nephropathy – rationale, study design, treatment plan and baseline characteristics of the incipient to overt: angiotensin II receptor blocker telmisartan, investigation on type 2 diabetic nephropathy (INNOVATION) Study. J Int Med Res 2005;33:677–686. INNOVATION was a placebo-controlled, prospective, randomized, double-blind, parallel-group study.1 It employed a 4-week run-in period, followed by up-titration over a period of 4 weeks to telmisartan 40/80 mg. Add-on antihypertensive therapy (?-blocker, CCB, non-potassium sparing diuretics) was allowed to ensure adequate control of blood pressure in both treatment arms. The total duration of active treatment was 52 weeks. Makino H, et al. The telmisartan renoprotective study from incipient nephropathy to overt nephropathy – rationale, study design, treatment plan and baseline characteristics of the incipient to overt: angiotensin II receptor blocker telmisartan, investigation on type 2 diabetic nephropathy (INNOVATION) Study. J Int Med Res 2005;33:677–686. The primary outcome measure was the transition to clinical nephropathy, defined as a first-morning voided urine albumine/creatinine ratio >300 mg/g creatinine and >30% increase from baseline. Secondary endpoints included: changes in the urinary albumine/creatinine ratio normalization rate of urinary albumine/creatinine ratio (<30 mg/g) changes in serum creatinine changes in serum creatinine clearance changes in urinary collagen Type IV composite of a doubling of serum creatinine concentration, ESRD or death composite of mortality and morbidity from cardiovascular disorders.