{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,18]],"date-time":"2026-09-18T18:41:56Z","timestamp":1789756916983,"version":"4.0.1"},"reference-count":46,"publisher":"American Diabetes Association","issue":"12","content-domain":{"domain":["diabetesjournals.org"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2003,12,1]]},"abstract":"<jats:p>OBJECTIVE\u2014Irbesartan is renoprotective in patients with type 2 diabetes and microalbuminuria. Whether the observed reduction in microalbuminuria is reversible (hemodynamic) or persistent (glomerular structural\/biochemical normalization) after prolonged antihypertensive treatment is unknown. Therefore, the present substudy of the Irbesartan in Patients with Type 2 Diabetes and Microalbuminuria Study (IRMA-2) investigated the reversibility of kidney function changes after withdrawal of 2 years\u2019 antihypertensive treatment.<\/jats:p>\n               <jats:p>RESEARCH DESIGN AND METHODS\u2014The substudy included 133 hypertensive type 2 diabetic patients with persistent microalbuminuria in IRMA-2, randomized to double-masked treatment with either placebo, irbesartan 150 mg, or irbesartan 300 mg o.d. for 2 years. Arterial blood pressure, overnight urinary albumin excretion rate, and glomerular filtration rate (GFR) were determined repeatedly.<\/jats:p>\n               <jats:p>RESULTS\u2014Baseline characteristics were similar in the placebo, irbesartan 150-mg, and irbesartan 300-mg groups. At the end of the study, mean arterial blood pressure (MABP) was similarly lowered to 105 \u00b1 2 (mean \u00b1 SE), 103 \u00b1 2, and 102 \u00b1 2 mmHg, respectively (P &amp;lt; 0.05 versus baseline), and urinary albumin excretion rate reduced by 8% (\u221216 to 27) (NS), 34% (95% CI 8\u201353), and 60% (46\u201370) (P &amp;lt; 0.05). Rates of decline in GFR were 1.3 \u00b1 0.7, 1.2 \u00b1 0.7, and 1.0 \u00b1 0.8 ml \u00b7 min\u22121 \u00b7 1.73 m\u22122 per month, respectively, during the initial 3 months of the study and 0.3 \u00b1 0.1, 0.3 \u00b1 0.1, and 0.4 \u00b1 0.1 ml \u00b7 min\u22121 \u00b7 1.73 m\u22122 per month in the remaining study period. One month after withdrawal of all antihypertensive medication, MABP remained unchanged in the placebo group, 105 \u00b1 2 mmHg, but increased significantly in the irbesartan groups, to 109 \u00b1 2 and 108 \u00b1 2 mmHg, respectively. Compared with baseline, urinary albumin excretion rate was increased by 14% (\u221217 to 54) in the placebo group and by 11% (\u221226 to 65) in the irbesartan 150-mg group but was persistently reduced by 47% (24\u201373) in the irbesartan 300-mg group (P &amp;lt; 0.05). GFR levels increased to baseline values in the placebo group and approached initial levels in irbesartan groups.<\/jats:p>\n               <jats:p>CONCLUSIONS\u2014Persistent reduction of microalbuminuria after withdrawal of all antihypertensive treatment suggests that high-dose irbesartan treatment confers long-term renoprotective effects.<\/jats:p>","DOI":"10.2337\/diacare.26.12.3296","type":"journal-article","created":{"date-parts":[[2007,3,5]],"date-time":"2007-03-05T22:51:27Z","timestamp":1173135087000},"page":"3296-3302","update-policy":"https:\/\/doi.org\/10.2337\/ada-journal-policies","source":"Crossref","is-referenced-by-count":72,"title":["Kidney Function During and After Withdrawal of Long-Term Irbesartan Treatment in Patients With Type 2 Diabetes and Microalbuminuria"],"prefix":"10.2337","volume":"26","author":[{"given":"Steen","family":"Andersen","sequence":"first","affiliation":[{"name":"Steno Diabetes Center, Gentofte, Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jens","family":"Bro\u0308chner-Mortensen","sequence":"additional","affiliation":[{"name":"Department of Clinical Physiology, Aalborg Sygehus, Aalborg, Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hans-Henrik","family":"Parving","sequence":"additional","affiliation":[{"name":"Steno Diabetes Center, Gentofte, Denmark"},{"name":"University of Aarhus, Faculty of Health Science, Aarhus, Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"Irbesartan in Patients With Type 2 Diabetes and Microalbuminuria Study Group","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1167","reference":[{"key":"2022031214531357900_R1","unstructured":"Blantz RC, Gabbai FB: Effect of angiotensin II on glomerular hemodynamics and ultrafiltration coefficient. 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