Preemptive Olmesartan for the Delay or Prevention of Microalbuminuria in Diabetes

Patients with either type 1 or type 2 diabetes mellitus are at high risk for chronic kidney disease, which is usually first evident with the onset of microalbuminuria. There is overall consensus that agents that block the renin–angiotensin system — particularly angiotensin-converting–enzyme (ACE) inhibitors and angiotensin-receptor blockers (ARBs) — slow the progression of chronic kidney disease in patients with diabetes who already have microalbuminuria. Long-term trials with losartan (the Reduction of Endpoints in NIDDM with the Angiotensin II Antagonist Losartan [RENAAL] trial)1 and irbesartan2 showed that ARBs slowed the course of diabetic nephropathy in patients with baseline evidence of renal . . .