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Inhibition of the renin-antiotensin system is the main therapeutic used to reduce the progression of kidney disease in diabetic nephropathy, and to reduce cardiac fatalities due to arterial hypertension; demonstrated through the Advance and Ascot study. The ASCOT-BPLA trial underlines the cardiovascular benefit of ACE inhibitors, specifically perindopril, beyond that provided by BP reduction, and potentially reflects a mechanistic feature of the ACE inhibitors. Perindopril may provide broad-spectrum cardiovascular protection, as well as reduce the incidence of new-onset diabetes mellitus and renal impairment, in addition to its efficacy in lowering BP (1). A reduction in systo-diastolic values amounting to 9/8 mmHg, with a significant decrease in all-cause mortality (-14%), cardiovascular mortality (-18%) were observed from the results of ADVANCE trial arm published in 2007. Treatment with perindopril/indapamide fixed combination had been reported to provide significant renal benefits (2). Renal outcomes were improved with combination treatment, which was associated with clearcut reductions in the risk of developing microalbuminuria, in the risk of developing overt nephropathy or worsening renal function (overall risk reduction -21%, P< 0.0001) (). We decided to investigate the reduction in mortality and the improvement in kidney function as well as the reduction in the risk of nephropathy in patients who started taking perindopril
Prospective, descriptive study, with individuals over 20 years of age of any sex, treated at the Chimaltenango Diabetes and Kidney Center, Guatemala during 2021 to 2022. Patients under 20 years of age were excluded. Patients with stages III and IV of the K/DIGO renal failure classification were included. The patients were divided into two groups: those who took perindopril and those who decided not to take perindopril.Both groups were classified according to their kidney function and were followed up. OBJECTIVES: Primary: Determine the reduction in mortality of patients with type II Diabetes and Arterial Hypertension stages I and II of the ESC classification of arterial hypertension with Chronic Renal Failure.Secondary: Improvement in kidney function, Fall in Dialysis
From a sample of 1228 patients, a sample of 155 patients was obtained. Prevalence of women in 60.5%, over 50 in 55%, with a general average age of 52 years.The most frequent risk factors, diabetes over 15 years of age, dyslipidemia, heart failure.The patients at one year had a decrease in mortality, a decrease in blood pressure and a decrease in creatinine in all kidney failure groups.The improvement in pressure occurred in 94.5% of patients in stage IIIa, 96% in stage IIIb and 80% in stage IV. The improvement in creatinine and glomerular filtration rate improved in all groups but was much better in stages III. Those who did not take perindopril fell more on dialysis and had higher mortality in all groups
CONCLUSION: Perindopril reduces mortality with improvement kidney function and decline in dialysis