Dr Tanveer Ahmad Tahir, Dr Sirajulhaq, Dr Noor Khan
Aim: The aim of this study is to determine the Effect of ACE inhibitors on Creatinine Clearance and albuminuria in diabetic nephropathy. Place and Duration: In the nephrology department of Services Hospital Lahore for one-year duration from March 2019 to March 2020. Methods: Thirty diabetic patients were tested for the effect of ramipril on creatinine clearance and albuminuria. They all had type 2 diabetes and were taking oral hypoglycemic drugs. They all had varying degrees of hypertension. Ramipril was taken for 3 months at a variable dose ranging from 5 to 10 mg / day. Creatinine clearance and albuminuria were determined before and after treatment. The patients were divided into 3 groups: Group 1: 10 patients with albuminuria and mild hypertension. Group 2: 10 patients with albuminuria and moderate hypertension. Group 3: 10 patients with macroalbuminuria and moderate to severe hypertension. Results: In our study, Group 1 achieved the maximum benefit from ramipril in terms of a very significant reduction (P = 0.002) of creatinine clearance and albuminuria, which significantly improved (P = 0.001). Group 2 was less successful with only a significant decrease in albuminuria (P = 0.005), but with a slight decrease in creatinine clearance. Group 3 with macroalbuminuria did not benefit from the effect of ramipril on albuminuria, but there was a significant decrease in creatinine clearance below normal levels (p = 0.001). Conclusion: Early and strict blood pressure control with ramipril is necessary for successful treatment of diabetic nephropathy with microalbuminuria. In our study, patients with macroalbuminuria did not benefit from treatment with ramipril.