Combination drug delays onset of kidney disease

The antihypertensive pill containing an angiotensin-converting enzyme inhibitor and a non-dihydropryridine calcium channel blocker has been shown to reduce the incidence of microalbuminuria when compared with standard treatment, according to a study published recently in the New England Journal of Medicine.

Microalbuminuria, or small amounts of protein in the urine, is an early indicator of kidney disease and has been associated with an increased risk of cardiovascular problems.

The Bergamo Nephrologic Diabetes Complication Trial (BENEDICT) examined the effects of various combinations of the ACE inhibitor, trandolapril, and the non-dihydropyridine calcium channel blocker, verapamil, during the onset of microalbuminuria in more than 1,200 patients with type 2 diabetes and hypertension for about three and a half years.

The BENEDICT study results underscore the potential role of combination antihypertensive medicine in delaying the onset of microalbuminuria, which is an important treatment goal for individuals with hypertension and diabetes.

"Independent of blood pressure, the study showed that the combination of trandolapril/verapamil was able to reduce the incidence of kidney disease in the high-risk diabetic hypertensive patients who, for all intents and purposes, have normal kidney function," said Dr. Loewe Go, a consultant at the Heart Institute of St. Luke’s Medical Center.

In addition, the study noted that the trandolapril/verapamil combination helped patients reduce blood pressure with fewer additional medications.

By 2030, there will be about 370 million people worldwide with type 2 diabetes and approximately one-third of them will develop nephropathy and require dialysis therapy.

About 10,000 Filipinos suffer from end-stage renal disease each year, according to data from the National Kidney and Transplant Institute. More than half of them are due to diabetes and hypertension.

The trandolapril/verapamil combination in a fixed dose combination will soon be available as a prescription medicine.