VA NEPHRON-D

Veterans Affairs Nephropathy in Diabetes

Patient / Population Intervention / Exposition Comparaison Critère de jugement

In 1,448 patients with type 2 diabetes and albuminuric CKD, dual blockade with losartan plus lisinopril did not reduce the renal composite compared with losartan alone.

1 448

Schéma

Double-blind RCT, stopped early for safety

Critère

eGFR decline, ESRD or death

Pertinence

RésultatHR 0.88 (95% CI 0.70–1.12; p=0.30); hyperkalaemia HR 2.8 and AKI HR 1.7 (both p<0.001).

Fried LF, et al. N Engl J Med. 2013;369(20):1892-1903. 10.1056/NEJMoa1303154

Discussion et critique

Definitive end to dual RAS blockade; KDIGO explicitly recommends against it.