How ACE Inhibitors Protect the Kidneys of Diabetic Patients

• Diabetes is the number one cause of kidney failure in people, and can result in chronic kidney disease and kidney failure. One-third of all patients with type 2 diabetes develop a progressive deterioration of their kidney function. When your kidneys fail, you must have regular dialysis treatment, a blood-cleaning procedure; or a kidney transplant, where you undergo surgery to receive a healthy kidney from a donor.
  
  The good news is that ACE (angiotensin-converting enzyme) inhibitors, that are commonly prescribed to control blood pressure, have been shown to be effective in slowing the progression of kidney disease. People who cannot take ACE inhibitors may be able to switch to ARBs (angiotensin receptor blockers) to get the same results.
  
  

ACE Inhibitors and ARBs

• In addition to lowering blood pressure, ACE inhibitors may protect the kidneys from damage. Doctors prescribe ACE inhibitors for the treatment of kidney disease. ACE inhibitors can also slow deterioration of the kidneys in people with diabetes who do not have high blood pressure.
  
  ACE inhibitors include the drugs: Capoten (captopril), Prinivil and Zestril (lisinopril), Vasotec (enalapril), Lotensin (benazepril), Altace (ramipril), Accupril (quinapril), Monopril (fosinopril), Mavik (trandolapril), Aceon (perindopril) and Univasc (moexipril). The ARB losartan (Cozaar) has also been shown to protect kidney function while lowering the risk of cardiovascular events.
  
  

How ACE Inhibitors Work

• Research in 2004 at the Unit of Diabetology of the Bergamo Hospital, in Bergamo, Italy, showed that ACE inhibitors prevent the development of microalbuminuria in people with type 2 diabetes. This is important because people with type 2 diabetes can develop an increase of albumin or microalbuminuria in their urine; an early sign of kidney disease. "Our results demonstrate that microalbuminuria can be prevented in type 2 diabetes," the authors of the study conclude. "The apparent advantage of ACE inhibitors over other agents includes a protective effect on the kidney against the development of microalbuminuria, which is a major risk factor for cardiovascular events and death in this population." If you have with even mild hypertension or persistent microalbuminuria, you should ask your doctor about using an ACE inhibitor.
  
  

Potential Side Effects When Using ACE Inhibitors

• In rare occasions, ACE inhibitors can cause low blood sugar (hypoglycemia); serious or fatal liver problems; or allergic reactions. Contact your doctor immediately if you experience: lightheadedness, dizziness, nausea, sweating and loss of consciousness; yellowing of the eyes or skin, dark urine, stomach pain, persistent fatigue, persistent nausea; rash, itchiness, swelling of the face, lips, tongue, or throat, or you have trouble breathing. If an ACE inhibitor causes you to cough, you should ask your doctor if you can take an ARB instead.
  
  

Who Should Not Use an ACE Inhibitor

• If you have arterial stenosis, impaired renal function, impaired liver function, or aortic stenosis, you are prone to hypotension or hyperkalemia or you have a hypersensitivity to other medications in the class, you shouldn't take ACE inhibitors.