[SOLVED] answer this question 2 paragraphs needed

I don’t know how to handle this Health & Medical question and need guidance.

Struggling to find relevant content or pressed for time? – Don’t worry, we have a team of professionals to help you on
[SOLVED] answer this question 2 paragraphs needed
Get a 15% Discount on this Paper
Order Now

Need 2 paragraphs with sources on this prompt.

What clinical trial endpoints have been shown to improve when ACE inhibitors and/or ARBS are used in preventing the progression of kidney disease in patients with diabetes? Which patients with diabetes benefit the most? At what point is it recommended that an ACE inhibitor or ARB be initiated in a patient with diabetes?

Formulate a response to this discussion. Need 2 paragraphs

In the study Role of ACE inhibitors in Patients with Diabetes Mellitus the results showed that that not only do ACE inhibitors help to slow the progression of kidney disease but that they also help with the protection of other organs. “ACE inhibitors have been reported to improve kidney, heart, and to a lesser extent, eye and peripheral nerve function of patients with diabetes mellitus.” This study was more directed at providing evidence of adding the ACE inhibitor earlier in therapy because it could help prevent other complications in the future such as kidney disease. ACE inhibitors are already indicated in patients with hypertension. I can understand their thought process in doing this but only in high risk diabetes patients for high blood pressure, mainly type 2 diabetes. The patients that benefit the most from taking an ACE or an ARB for preventing the progression of kidney disease is someone who has hypertension or proteinuria. I would also argue that someone who could benefit the most is someone who is high risk for hypertension. Overall there is a lot of evidence from lots of studies pointing towards ACE inhibitors and ARBs being given in patients with both diabetes and hypertension, and this is why it’s initiated after patients have both.



Formaulate response to this discussion. Need 2 paragraphs.

There is a renoprotective effect that ARBs and ACE inhibitors possess that makes them a good candidate to help prevent kidney issues within patients with diabetes. There is evidence for ACE inhibitors in type 1 and ARBs for type 2 diabetes to reduce progression in both diseases. For ACE inhibitors this is seen because of moderately increased albuminuria, there was a study where a diabetic patient had decreased albumin excretion and after two years of disease progression the patients on ACE inhibitors had less albuminuria than those with placebo. There was another study that had overt nephropathy and randomly assigned therapies with either captopril or a placebo. After 4 years patients with captopril had slower rate of creatine increases with less likelihood of progressing to end stage renal disease. This however only worked for patients with creatine of greater than 1.5 mg/dL and it was reduced by 50% per year compared to placebo group. There was no improvement for those with lower baseline plasma creatinine concentration because the rate of progression is slow. Some patients had antiproteinuric effects with remission or regression of nephropathy, 40 were randomly assigned to active therapy with captopril and after 7.7 years 6 patients were still in remission with lower proteinuria after using an ACE inhibitor of captopril. Aggressive blood pressure therapy has been connected with remission and regression. After treatment with ACE inhibitors the rate of decline in GFR was faster after a nine year follow up.

A good reason this method is effective has to do with good blood pressure control and management is a key factor in preventing progression of diabetic nephropathy. United Kingdom Prospective Diabetes Study determined that 10 mmHG reduction in systolic pressure gives a 12% decrease in risk for diabetic complications. This would indicate that by utilizing these avenues of ACE inhibitor or ARBs to control blood pressure would indirectly reduce a patient’s risk of developing kidney disease complications.

Both diabetic types receive effects from this type of treatment, however it was found that ARBs have better efficacies and that could be a better form for treatment in both type 1 and type 2. With that said, ACE inhibitors have been frequently tested in type 1 diabetics whereas ARBs were tested in type 2. Both had seemingly congruent results that lead to believe either treatment would be recommended but distinguished in which type of diabetes a patient is suffering from.

Patients with urinary albumin excretion rates of 30 to 300 mg in 24 hours are those who should be prescribed these medications in order to utilize this special property for stalling of diabetic nephropathy disease in both type 1 and type 2 diabetic patients which was recommended by the The Kidney Disease: Improving Global Outcomes guidelines . After doing a lot of research on this topic my results found that the best method for this prevention of diabetic kidney disease is by using both an ACE inhibitor and ARB together to have a greater reduction in protein excretion, but it was concluded to not use these medications at the same time as it increases likelihood of adverse events.. There however is more data for ARB efficacy rather than ACE inhibitors with this indication.

Calculate the price
Make an order in advance and get the best price
Pages (550 words)
$0.00
*Price with a welcome 15% discount applied.
Pro tip: If you want to save more money and pay the lowest price, you need to set a more extended deadline.
We know how difficult it is to be a student these days. That's why our prices are one of the most affordable on the market, and there are no hidden fees.

Instead, we offer bonuses, discounts, and free services to make your experience outstanding.
How it works
Receive a 100% original paper that will pass Turnitin from a top essay writing service
step 1
Upload your instructions
Fill out the order form and provide paper details. You can even attach screenshots or add additional instructions later. If something is not clear or missing, the writer will contact you for clarification.
Pro service tips
How to get the most out of your experience with MyCoursebay
One writer throughout the entire course
If you like the writer, you can hire them again. Just copy & paste their ID on the order form ("Preferred Writer's ID" field). This way, your vocabulary will be uniform, and the writer will be aware of your needs.
The same paper from different writers
You can order essay or any other work from two different writers to choose the best one or give another version to a friend. This can be done through the add-on "Same paper from another writer."
Copy of sources used by the writer
Our college essay writers work with ScienceDirect and other databases. They can send you articles or materials used in PDF or through screenshots. Just tick the "Copy of sources" field on the order form.
Testimonials
See why 20k+ students have chosen us as their sole writing assistance provider
Check out the latest reviews and opinions submitted by real customers worldwide and make an informed decision.
Social Work and Human Services
Great Job!
Customer 452587, October 27th, 2021
Other
great
Customer 452813, June 30th, 2022
History
thank you so much for the help, I really appreciate that.
Customer 452725, February 13th, 2022
English 101
thank you
Customer 452483, February 27th, 2021
Nursing
Thank you MyCoursebay team for your support. With your help I got an A for my past courses
Customer 452635, May 7th, 2022
Other
Thank you for a well written paper!!!
Customer 452557, January 19th, 2022
Criminal Justice
always great!
Customer 452465, February 23rd, 2021
Strategic Management
Thank you very much for the help, really appreciate it
Customer 452821, June 27th, 2022
Nursing
Amazing work! I passed the assignment!
Customer 452707, August 20th, 2022
Social Work and Human Services
Good Work!
Customer 452587, September 2nd, 2021
public speaking
The work was excelent and very professional.
Customer 452653, November 1st, 2021
Ethics
thank you
Customer 452493, March 15th, 2021
11,595
Customer reviews in total
96%
Current satisfaction rate
3 pages
Average paper length
37%
Customers referred by a friend
OUR GIFT TO YOU
15% OFF your first order
Use a coupon FIRST15 and enjoy expert help with any task at the most affordable price.
Claim my 15% OFF Order in Chat
NEW

Thank you for choosing MyCoursebay. Your presence is a motivation to us. All papers are written from scratch. Plagiarism is not tolerated. Order now for a 15% discount

Order Now