Microalbuminuria is an early predictor of diabetic nephropathy and premature cardiovascular disease( so we think). Some people might argue its a word that needs to be taken away from the medical dictionary. In 2011, NEJM published the ROADMAP trial. They wanted to show if the use of ARB would delay the onset of microalbuminuria or albuminuria in patients with Type 2 DM. In a randomized trial, over 4000 patients were either in olmesartan arm or placebo for close to 3 years. The primary outcome was the time to the first onset of microalbuminuria.
1. The target blood pressure (<130/80 mm Hg) was achieved in nearly 80% of the patients taking olmesartan and 71% taking placebo;
2. Microalbuminuria developed in 8.2% of the patients in the olmesartan group and 9.8% in the placebo group
3. The serum creatinine level doubled in 1% of the patients in each group.
4. Greater number had fatal cardiovascular events in the treatment arm — 15 patients (0.7%) as compared with 3 patients in the placebo arm (0.1%) (P=0.01), a difference that was attributable in part to a higher rate of death from cardiovascular causes.
This is striking. Causes:- was it hyperkalemia? was it lower blood pressure than we think should be for DMII. This was reviewed by FDA as well. Other renal blogs had mentioned this trial as well.
- ► 2019 (28)
- ► 2018 (57)
- ► 2017 (52)
- ► 2016 (45)
- ► 2015 (63)
- ► 2014 (95)
- Sweet hydrothorax: A PD complication
- CASE BASED DEBATES SESSION AT ASN 2013
- Quick Chemotherapy toxicity quiz flashcards using ...
- A glomerular disease simple flashcard using quizle...
- Harvard Macy Digital Citizen 2013 course
- Promoting Palliative care in ESRD
- TOPIC DISCUSSION: Renal biopsy findings in Diabeti...
- ANIO-ASN Dinner evite
- Clinical Case Answers and Summary 75
- Non renal causes of microalbuminuria
- ROADMAP: Did we forget to use this map?
- IN THE NEWS: Conservative management in CKD, and n...
- CONSULT ROUNDS: Hemophagocytic syndrome and the ki...
- Consult Rounds: Why does infusion of normal saline...
- ▼ October (14)
- ► 2012 (201)
- ► 2011 (370)
- ► 2010 (461)