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  • 1 Petz Aladár Megyei Oktató Kórház Kardiológiai Osztály Győr Vasvári Pál u. 2–4. 9024
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Az elmúlt két évtizedben a cukorbetegségben szenvedő betegek számának robbanásszerű növekedése figyelhető meg. Az International Diabetes Federation 2012-es adatai alapján több mint 371 millió ember szenved diabetes mellitusban, amely évente 4,8 millió ember haláláért felelős. A diabeteses nephropathia a végstádiumú veseelégtelenség leggyakoribb oka. Kialakulásának első jele a microalbuminuria. Hatékony kezelés nélkül a 2-es típusú diabetes mellitusban szenvedő microalbuminuriás betegek 20–40%-a válik klinikailag nephropathiássá, de csak 20%-uk lesz uraemiás, mert a többségük már előtte meghal, elsősorban cardiovascularis betegség miatt. A diabeteses nephropathia kialakulásában a renin-angiotenzin rendszernek – amely többek között a vérnyomás és só-víz háztartás szabályozásának egyik legfontosabb eleme – is szerepe van. Ennek működését befolyásoló gyógyszerek ma a magas vérnyomás betegség kezelésében központi jelentőséggel bírnak. A szerző a jelentősebb tanulmányokat és számos állatkísérlet eredményét áttekintve bemutatja, hogy az angiotenzinkonvertáló enzim inhibitor családba tartozó ramipril hol helyezkedik el ma a diabeteses nephropathia terápiájában. A szerző megállapítja, hogy a ramipril egyike a legtöbb evidence based eredménnyel rendelkező angiotenzinkonvertáló enzim gátlóknak, amely többek között a vérnyomáscsökkentő hatáson túlmutató célszervvédelem miatt a nagy nemzetközi, multicentrikus vizsgálatok alapján a diabeteses nephropathia kezelésénél is bizonyítottan kedvező hatású. Orv. Hetil., 2014, 155(7), 263–269.

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