The present study assessed the extent to which remission of nephrotic-range
proteinuria occurred in patients with Type I diabetes enrolled in the
Captopril Study, a placebo controlled multicenter clinical trial of
captopril therapy in
diabetic nephropathy. Of the 409 patients recruited into the
Captopril Study, 108 had nephrotic-range
proteinuria (> 3.5 g/24 hr) at entry in the Study (baseline). This group was the subject of the present study. Remission of nephrotic-range
proteinuria was defined as follows: (1) Onset of the remission was taken as the date when
proteinuria was first noted to be < or = 1.0 g/24 hr. (2) The reduction in
proteinuria had to be sustained for a minimum of six months and until the end of the
Captopril Study. (3) During the remission, the average of all 24 hour
proteinuria measurements could not exceed 1.5 g. (4) Decline in renal function could not explain the reduced
proteinuria. That is, the patient's serum
creatinine during the entire period of observation in the
Captopril Study had to remain at less than a doubling of the baseline serum
creatinine. Remission of nephrotic-range
proteinuria occurred in 7 of 42 patients assigned to
captopril (16.7%, mean follow-up 3.4 +/- 0.8 years) and in 1 of 66 patients assigned to placebo (1.5%, mean follow-up 2.3 +/- 1.1 years; P = 0.005, comparing remission rate in
captopril vs. placebo-treated patients).(ABSTRACT TRUNCATED AT 250 WORDS)