Jefferson wrote:
> There have been a few threads on kidney function in the last 12 months.
> As some of you may know the units for measuring creatinine are not very
> large, i.e., 1.0 mg/dl, 1.6 mg/dl, etc. Yet the difference in serum
> creatinine level of a few tenths of mg/dl can change the stage for
> kidney function diagnosis. Not so incidentally, one of the most commonly
> used oral diabetes medications, metformin, is not recommended for
> patients with significant kidney dysfunction. Diabetics should become
> familiar with the terms and tests used for kidney function so they will
> understand what it means to them personally.
>
(snipped)
After 6 months from the initial date of publication, New England Journal
of Medicine articles are free with subscription.
Preventing Microalbuminuria in Type 2 Diabetes -
http://content.nejm.org/cgi/content/...ct/351/19/1941
ABSTRACT
Background The multicenter double-blind, randomized Bergamo Nephrologic
Diabetes Complications Trial (BENEDICT) was designed to assess whether
angiotensin-converting–enzyme inhibitors and non-dihydropyridine
calcium-channel blockers, alone or in combination, prevent
microalbuminuria in subjects with hypertension, type 2 diabetes
mellitus, and normal urinary albumin excretion.
Methods We studied 1204 subjects, who were randomly assigned to receive
at least three years of treatment with trandolapril (at a dose of 2 mg
per day) plus
verapamil (sustained-release formulation, 180 mg per day),
trandolapril alone (2 mg per day), verapamil alone (sustained-release
formulation, 240 mg per day), or placebo. The target blood pressure was
120/80 mm Hg. The primary end point was the development of persistent
microalbuminuria (overnight albumin excretion, ≥20 µg per minute at two
consecutive visits).
Results The primary outcome was reached in 5.7 percent of the subjects
receiving trandolapril plus verapamil, 6.0 percent of the subjects
receiving trandolapril, 11.9 percent of the subjects receiving
verapamil, and 10.0 percent of control subjects receiving placebo. The
estimated acceleration factor (which quantifies the effect of one
treatment relative to another in accelerating or slowing disease
progression) adjusted for predefined baseline characteristics was 0.39
for the comparison between verapamil plus trandolapril and placebo
(P=0.01), 0.47 for the comparison between trandolapril and placebo
(P=0.01), and 0.83 for the comparison between verapamil and placebo
(P=0.54). Trandolapril plus verapamil and trandolapril alone delayed the
onset of microalbuminuria by factors of 2.6 and 2.1, respectively.
Serious adverse events were similar in all treatment groups.
Conclusions In subjects with type 2 diabetes and hypertension but with
normoalbuminuria, the use of trandolapril plus verapamil and
trandolapril alone decreased the incidence of microalbuminuria to a
similar extent. The effect of verapamil alone was similar to that of
placebo.
Frank
Kidney Function Revisited 
Linear Mode
