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The effect of angiotensin-receptor blockers (ARBs) on renal outcomes among patients at high vascular risk but without overt diabetic nephropathy and among normoalbuminuric patients with diabetes is unknown. In two reports, researchers examined the effects of ARBs in these groups.
In a 5-year industry-sponsored international randomized trial, investigators compared telmisartan (Micardis) with placebo in 5927 adults (mean age, 67) who could not tolerate angiotensin-converting–enzyme inhibitors. All participants had cardiovascular disease or diabetes and end-organ damage but no macroalbuminuria or heart failure. No significant difference was seen in the combined outcome of serum creatinine doubling or requisite dialysis; in fact, doubling of cr…