Efficacy of Aldosterone Antagonist with RAAS Blockade in Patients with Diabetic Kidney Disease

Background: The use of an angiotensin-converting enzyme inhibitor or angiotensin receptor blocker is now standard therapy for patients with diabetic kidney disease. However, this treatment is not fully effective in some patients.

Methods: A prospective observational study was conducted at SRN Hospital Allahabad on 600 diabetic kidney disease patients during July 2015 to August 2017 to compare the efficacy of triple blockade, double blockade and single blockade of renin-angiotensin-aldosterone system.

Results: At the end of the study, 24 hours urinary protein excretion rate was statistically compared between group I & group III and between group II & group III. The rate was found significant with p value (<0.0001) and (0.0003) respectively.

Conclusion: Triple blockade of the renin-angiotensin-aldosterone system was effective for the treatment of proteinuria in patients with diabetic kidney disease whose increased urinary protein had not responded sufficiently to a dual blockade.

Keywords: DKD, RAAS, Aldosterone antagonist, Double blockade, Triple blockade, Hyperkalemia.