Summary
Diabetic nephropathy is the dominant cause of hypertension in insulin-dependent diabetics,
and long-term rigid antihypertensive treatment inhibits the progression of nephropathy,
probably even when there is renal insufficiency. In our clinical study 14 insulin-dependent
diabetics with diabetic nephropathy and renal failure (glomerular filtration rate
[GFR] 0.39 ± 0.12 ml/sec) underwent rigid blood pressure treatment. Antihypertensive
therapy included f urosemide, propranolol, dihydralazin and nifedipine. The whole
group showed a lowering in mean blood pressures from 150.1 ± 2.3/91.3 ± 1.4 mm Hg
to 139.8 ± 3.1/86.5 ± 2.0 mm Hg (p < 0.01). During the observation period the mean
decline in glomerular filtration rate decreased from —0.022 ± 0.003 ml/sec per month
to —0.010 ± 0.007 ml/sec per month. In 10 out of 14 patients with very advanced nephropathy
the further decline of GFR halted markedly.
Thus, vigorous blood pressure control is able to postpone endstage renal disease even
in advanced diabetic nephropathy.
Key words
Insulin-dependent (type I) diabetes - Diabetic nephropathy - Renal failure - Hypertension
- Blood pressure control
