Diabetic Nephropathy Clinical Trial
Official title:
A Double-Blind, Placebo-Controlled Study on the Effect of Spironolactone, in Patients With Persistent Proteinuria on Long-Term Angiotensin Converting Enzyme Inhibitor Therapy, With or With Out an Angiotensin II Receptor Blocker
The purpose of this study is to determine which combination of the tablets ramipril, irbesartan or spironolactone is best to lower protein leakage from the kidney.
Protein leak from the kidney into the urine is an indicator of kidney damage. The higher the
leak, the worse the damage and the more likely the patient will lose their kidney function
long term. Interventions that lower protein leak make the kidneys last longer.
There are 2 groups of medications, both blood pressure tablets, the ACEI (angiotensin
converting enzyme inhibitors) and ATRB (angiotensin receptor blockers) which have shown to
reduce the amount of protein leaking from the kidney and as a result lengthen the life of
the kidney. There has also been evidence that using these 2 tablets in combination is better
than using either one alone. In spite of these tablets, there still remain some patients
that continue to leak protein in the urine.
Recently there has been evidence that the tablet spironolactone, which is a fluid tablet,
also reduces protein leakage from the kidney. In this study we look at various combinations
of these tablets to see which works best to lower protein leakage from the kidney.
Patients are divided into 4 groups. Each group will receive the tablet ramipril (an ACEI).
In group 1, patients will be on ramipril and 2 blank tablets, group 2 will be on ramipril,
irbesartan (an ATRB) and a blank tablet, group 3 will be on ramipril, spironolactone and a
blank tablet and group 4 will be on ramipril, irbesartan and spironolactone. Protein leakage
is measured at the beginning and after 3 months of treatment.
;
Allocation: Randomized, Endpoint Classification: Safety/Efficacy Study, Intervention Model: Parallel Assignment, Masking: Double-Blind, Primary Purpose: Prevention
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