Abstract

Background: Diabetic nephropathy (DN) is the leading cause of end-stage renal disease (ESRD) worldwide and is estimated that ~20% of type 2 diabetics develop ESRD during their lifetime. In type 2 diabetics with microalbuminuria, both enalapril and telmisartan have shown to reduce microalbuminuria, thereby delaying the progression of renal disease in diabetics.

Aim and Objective: This study aims to evaluate the efficacy of enalapril versus telmisartan among patients with DN for 6 months.

Materials and Methods: A prospective, open-labeled, randomized, comparative study was conducted involving 100 type 2 diabetics with mild hypertension and Grade I DN was divided randomly into two groups of 50 each, aged between 18 and 69 years with either sex, attending medicine outpatient department or admitted in medicine wards. One group received tab. enalapril maleate, 5–10 mg/day, while other group received tab. telmisartan, 40–80 mg/day, and were followed up once a month for 6 months. Efficacy was assessed using urine albumin, serum urea, serum creatinine, and blood pressure (BP).

Results: Demographic and baseline urine albumin level, serum urea, serum creatinine, and BP were comparable between two groups. Early improvement in urine albumin and serum creatinine levels was seen with enalapril (at 2 months, urine albumin: P = 0; at 3 months, serum creatinine: P = 0.007). Reduction of BP was greater with telmisartan (systolic BP/diastolic BP (DBP): P < 0.001). In later phase, no significant difference was observed between two groups among the parameters such as urine albumin estimation (P = 1) and serum urea (P = 0.286).

Conclusion: Both enalapril and telmisartan were equally efficacious in DN. However, enalapril had better response than telmisartan in our study.

Key words: Diabetic Nephropathy; Hypertension; Microalbuminuria; Enalapril Maleate; Telmisartan