The Effects of Blocking Angiotensin Receptors on Early Stages of Diabetic Nephropathy

Background: this study aimed to investigate the beneficial effectsof angiotensin receptor blockers (arbs) on markers of endothelialfunction in patients with early stage of diabetic nephropathy (dn).methods: this cross-sectional study was conducted on 32participants with iddm from january 2010 until may 2011 inisfahan, iran. the participants were candidate for receiving arbsor angiotensin?converting enzyme inhibitors (aceis) to decreasemicroalbuminuria. the inclusion criteria were as follows: the ageof onset of insulin?dependent diabetes mellitus (iddm)less than15 years; normal glomerular filtration rate (gfr); normal bloodpressure; normal cardiovascular examination; negative urine culture,receiving no medications except insulin. microalbuminuria wasmeasured in two fasting urine samples with a sampling interval ofat least 1–2 months by elisa method. patients with two abnormalresults were included. microalbumin to creatinin ratio equal to ormore than 30 mg/gm was considered abnormal. the fasting bloodsamples to determine serum nitric oxide (no) and vascular celladhesion molecule (vcam) were obtained at the time 0 (beforestarting the study), and after 2 months of receiving arbmedication.valsartan tablet (diovan, novartis company) with a dose of 1 mg/kg/day up to 80 mg/day in a single dose was administered.results: urine microalbumin to creatinin ratio after valsartanconsumption was lower than microalbumin level before themedication, p < 0.05. after valsartan consumption, serum vcam?1level reduced and no level increased significantly, p < 0.05.conclusion: angiotensin receptor blockers may reduce vcam?1and microalbuminuria and may increase no levels in early stagesof dn. thus administration of arbs might be considered even inearly stages of dn.