Background: In industrialised countries the incidence of type 2 diabetes-associated end stage renal disease has doubled over the last ten years. It is important to lower the blood pressure to inhibit progression of renal failure and to prevent micro- and macrovascular disease in these patients. There is an ongoing discussion on what should be the drug of choice.
Material and methods: We discuss the results from three landmark studies, recently published, on the use of angiotensin II antagonists in patients with type 2 diabetics and nephropathy.
Results and interpretation: All three studies found a renoprotective effect of angiotensin II antagonists that could not be explained by the effect on the blood pressure alone. Blockade of the renin angiotensin system with angiotensin II antagonist should be the basis of treatment in type 2 diabetic nephropathy.