Study Population

Inclusion Criteria

• Type 2 diabetes with incipient nephropathy
• First-morning voided urine albumin/creatinine ratio 100–300 mg/g creatinine
• Serum creatinine:
  • women <115 µmol/L (1.3 mg/dL)
  • men <133 µmol/L (1.5 mg/dL)
• Normotensive or hypertensive
• Out-patients
• Age 30–74 years
• Able to stop current antihypertensive therapy (ACE inhibitors or ARBs)
• Ability to provide written informed consent

Exclusion Criteria

• Type 1 diabetes
• Onset of diabetes <30 years
• Seated blood pressure ≥ 180/100 mmHg
• Chronic kidney disease other than diabetic nephropathy
• Current use of:
  • digoxin
  • ACE inhibitors or ARBs (except study drugs)
  • potassium-sparing diuretics (spironolactone, triamteren, potassium canrenoate, eplerenone), or
  • antiarrhythmic agents except beta-blockers and calcium channel blockers (bepridil hydrochloride, diltiazem hydrochloride, verapamil hydrochloride)

References