Evaluation of using Antihipertensi of Angiotensin Renin system to kidney protection on Diabetic patient in X hospital of Yogyakarta

Rita Suhadi, Imono Argo Donatus, B. Sidarto


The renin-angiotensin-system antihypertensive drugs (RAS), i.e. Angiotensin Converting Enzyme Inhibitors (ACEIs) and Angiotensin II Receptor Antagonists (AIIRAs) are prescribed for diabetes patients to slow the nephropathy progression. There are only limited clinical evidence of the RAS for Indonesian patients. This study aimed at assessing the antihypertensive drug selection and the renoprotective effect on Indonesian patients.
The study was done with retrospective survey and descriptiveevaluative design. A total of 116 diabetic patients were participated in the drug selection assessment and the renoprotective effect among 52 patients was analyzed by Kruskal-Wallis non-parametric statistics.
The results showed that the antihypertensive drug selection consisted of RAS (ACEIs 48% and AIIRAs 11%), non-RAS 22%, and without antihypertensive drugs 19%. The RAS antihypertensive drugs were administered at 53%; 56%; 92%; and 71% by normal; mild; moderate; and severe kidney dysfuntion patients respectively.
The annual clearance creatinine (Clcr) reduction were 3.93; 9.95; 0.85ml/min and the Clcr reduction in 23 months were 9.27; 8.66; 7.76% for non-RAS; without; and RAS antihypertension respectively, but the effects were not significantly different (p>0.05). In conclusion, renoprotection on diabetic patients by RAS was not more superior than that by non-RAS
antihypertensive drugs.
Key words: Diabetic Nephropathy, Renoprotection, ACE-Inhibitors (ACEI), Angiotensin II Receptor Antagonists (AIIRA).

Full Text:



Anonim, 2003, 2,5 Juta Penduduk Indonesia Meninggal Kena Kencing Manis, www.depkes.go.id/ind/news/2003. Diakses 2 Juni 2003.

Bakris, G,L., 2003, The Evolution of Treatment Guidelines for Diabetic Nephropathy, Strategies Integrate JNC VI, More Recent Protocols, 113,5,May2003/POSTGRADUATE MEDICINE, http://www.postgradmed.com/issues/2003/05-03/bakris.htm. Diakses 25 Juni 2003.

Brenner, B.M., Cooper, M.E., Zeeuw, D., Keane W.F., Mitch W.E., Parving H.H., Remuzzi G., Snapinn, S.M., Zhang Z., Shahinfar, S., Effects of Losartan on Renal and Cardiovascular Outcomes in Patients with Type 2 Diabetes and Nephropathy, N Engl J Med, 345,12 , Sep 20,2001. www.nejm.org. Diakses 20 Desember 2001.

Chobanian, A.V., Bakris, G.L., Black, H.R., Cushman, W.C., Green, L.A., Izzo, J.L..Jr., Jones, D.W., Materson, B.J., Oparil, S., Wright, J.T., Rocella, E.J., The Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure. The JNC 7 Report, in JAMA 2003,289,19 (Reprinted).

Lewis, E.J., Hunsicker, L.G., Clarke,W.R., Berl., T., Pohl, M.A., Lewis, J.B., Ritz., E., Atkins, R.C., Rohde, R., Raz, I., 2001, Renoprotective Effect of the Angiotensin-Receptor Antagonist Irbesartan in Patients with Nephropathy due to Type 2 Dibetes, N Engl J Med, 345,12, 851-860.

Molith ME, DeFronzo RA, Franz MJ, Keane WF, Mogensen CE, Parving HH, Steffles MW, 2002, Diabetic Nephropathy, American Diabetic Association, in Diabetes Care,25, Suppl 1.

Neutel, J.M., 2002, The Use of Combination Drug Therapy in the Treatment of Hypertension, http://www.medscape.com/viewarticle/436706. Diakses Agustus 2002.

Soman, S.S., Soman, A.S., Rao, T.K.S., 2002, Diabetic Nephropathy http://www.emedicine.com/med/topic549.htm. Diakses 25 Juni 2003.

DOI: http://dx.doi.org/10.14499/indonesianjpharm0iss0pp177-184


  • There are currently no refbacks.


Creative Commons License
This work is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License.

Indonesian J Pharm indexed by:

analytics View My Stats