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Основные исследования у больных с ХБП диабетической и недиабетической природы
| Название исследования | Дизайн, длительность наблюдения | Группа наблюдения | Режимы лечения | Основной результат |
| AIPRI The Angiotensin-converting-enzyme Inhibition in Progressive Renal Insufficiency Study, 1996 | Двойное слепое, плацебо-контролируемое, 3 года | N=583, исходный уровень Кр от 1,5 до 4,0 мг/дл и ККр (в 24-часовой порции мочи) 30-60 мл/мин. | Беназеприл 10 мг/сут Плацебо | Ингибитор АПФ замедляет прогрессирование нарушения функции почек различного происхождения. Антипротеинурический эффект ингибитора АПФ |
| MDRD The Modification of Diet in Renal Disease, 1995, 1997 | Проспективное, рандомизированное, 2,2 года | N=840, исходный уровень Кр 1,2-7,0 мг/дл (106-619 мкмоль/л) для женщин и 1,4-7,0 мг/дл для мужчин (124-619 мкмоль/л) или ККр <70 мл/мин. 724 пациента (86%) имели АГ | Обычный контроль АД (среднее АД ≤107 мм рт.ст. для пациентов ≤60 лет и ≤113 мм рт.ст. для пациентов >60 лет) Строгий контроль АД (среднее АД ≤92 мм рт.ст. для пациентов ≤60 лет и ≤98 мм рт.ст. для пациентов >60 лет) | Протеинурия - независимый фактор риска прогрессирования почечной недостаточности. Преимущество более строгого контроля АД и ограничения белка для замедления прогрессирования ХБП при выраженной протеинурии |
| ONTARGET (ONgoingTelmisartan Alone and in Combination With Ramipril Global Endpoint Trial), 2008 | Двойное слепое, 56 мес | Высокий риск сердечно-сосудистых осложнений, n=25620 | Рамиприл 10 мг /сут Телмисартан 80 мг/сут Рамиприл 10 мг/сут + телмисартан 80 мг/сут | Сопоставимые эффекты телмисартана и рамиприла в отношении почечных исходов. Более выраженное снижение протеинурии, но ухудшение других почечных исходов при применении комбинации по сравнению с монотерапией |
| ACCOMPLISH (Avoiding Cardiovascular Events through Combination Therapy in Patients Living with Systolic Hypertension), 2008, 2010 | Двойное слепое, 2,9 года | Изолированная систолическая АГ, n=11506 | Беназеприл 40 мг + Амлодипин10 мг Беназеприл 40 мг + Гидрохлоротиазид 25 мг | При применении беназеприла/ амлодипина по сравнению с беназеприлом/ гидрохлоротиазидом ниже риск удвоения креатинина сыворотки, но реже восстановление нормоальбуминурии и регресса повышенной альбумиурии |
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