A 50 year old male with type 2 diabetes mellitus is found to have 24 hr urinary albumin of 250 mg. Which of the following drugs may be used to retard progression of renal disease:
High-Yield Explanation
Answer is B (Enalapril): ACE inhibitors and Angiotensin Receptor Blockers are specifically indicated to reduce progression of renal disease. Either ACE inhibitors or ARB's should be used to reduce the progression from microalbuminuria to macroalbuminuria, and the associated decline in GFR. Drug specific benefit in diabetic nephropathy independent of blood pressure control has been shown only for ACE inhibitors and ARB's in patients with DM- Harrison