VA NEPHRON-D
Veterans Affairs Nephropathy in Diabetes
Paziente / Popolazione Intervento / Esposizione Confronto Esito
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.
N
1448
Disegno
Double-blind RCT, stopped early for safety
Esito
eGFR decline, ESRD or death
Rilevanza
2
RisultatoHR 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
Discussione e critica
Definitive end to dual RAS blockade; KDIGO explicitly recommends against it.