Captopril-DN

Captopril in Diabetic Nephropathy (Collaborative Study Group)

Patient / Population Intervention / Exposure Comparison Outcome

In 409 patients with type 1 diabetes and diabetic nephropathy, captopril reduced doubling of serum creatinine compared with placebo.

409

Design

Double-blind RCT, median 3-year follow-up

Endpoint

Doubling of baseline serum creatinine

Relevance

Result48% risk reduction in doubling of serum creatinine (HR ~0.52, 95% CI 0.31–0.84; p=0.007); ~50% reduction in death, dialysis, or transplantation.

Lewis EJ, et al. N Engl J Med. 1993;329(20):1456-1462. 10.1056/NEJM199311113292004

Discussion & critique

First proof of renoprotection beyond blood-pressure lowering; established ACE inhibitors as standard in type 1 diabetic nephropathy. Limited to T1DM with no blood-pressure-equivalent control arm.