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Effects of Diltiazem or Lisinopril on Massive Proteinuria Associated with Diabetes Mellitus

George L. Bakris, MD
[+] Article, Author, and Disclosure Information

Grand Support: By grants from the Alton Ochsner Medical Foundation and American Diabetes Association, Louisiana Affiliate.

Requests for Reprints: George L. Bakris, MD, Ochsner Clinic, Section on Nephrology, 1514 Jefferson Highway, New Orleans, LA 70121.

Current Author Address: Dr. Bakris: Ochsner Clinic, Section on Nephrology, 1514 Jefferson Highway, New Orleans, LA 70121.

Ann Intern Med. 1990;112(9):707-708. doi:10.7326/0003-4819-112-9-707
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This excerpt has been provided in the absence of an abstract.

Recent studies in hypertensive, diabetic rats have shown that angiotensin-converting enzyme inhibitors reduce urinary protein excretion and preserve renal function to a greater extent than other antihypertensive agents (1, 2). The effects of calcium channel antagonists on urinary protein excretion and renal hemodynamics vary (3, 4). The renal hemodynamic effects of diltiazem, however, have been shown to be similar to angiotensin-converting enzyme inhibitors (5, 6). We did a prospective crossover trial with diltiazem or lisinopril in eight diabetic, hypertensive patients with nephrotic-range proteinuria to compare the renal effects of these agents.

Patients and Methods: Eight noninsulin-dependent diabetic patients (three men


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