Diabetes Complications and the Renin–Angiotensin System

The hypothesis that inhibition of the renin–angiotensin system may be effective in preventing diabetic nephropathy was based on a large body of evidence.1 Positive findings from studies in animal models and subsequent clinical trials fostered enthusiastic hope that systematic use of agents blocking the renin–angiotensin system in the management of diabetic nephropathy would reduce the risk of end-stage renal disease.24 Out of such studies was born a concept that gained wide acceptance: inhibition of the renin–angiotensin system in patients with diabetes is beneficial with regard to both early and advanced stages of nephropathy. As an extension, studies were initiated . . .