RENAAL Trial Key Points
1. Losartan was found to have significant reno-protective role in patients with type II diabetes and nephropathy.
2. Losartan did not affect mortality in this patient population.
3. Proteinuria significant improved in patients taking losartan compared to placebo.
4. The IDNT trial tested irbesartan and reported similar renoprotective role in diabetic nephropathy.
Guideline Recommendations based on RENAAL Trial:
The JNC8 guidelines recommend: In patients who are diabetic with high levels of albuminuria, the medication regimen should include an ACE inhibitor or an ARB alone or in combination with medication from another drug class for treatment of HTN.
The KDIGO guidelines recommend use of an ACE or an ARB and a BP goal <130/80 mmHg in all patients with CKD and albuminuria irrespective of diabetes status. Source