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Correspondence
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Volume 334:1271-1272 May 9, 1996 Number 19
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Losartan-Induced Azotemia in a Diabetic Recipient of a Kidney Transplant

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To the Editor: In patients with diabetic nephropathy, angiotensin-converting–enzyme (ACE) inhibitors reduce blood pressure and the progression of nephropathy,1 but approximately 10 percent of patients have side effects that cause the discontinuation of ACE-inhibitor therapy.2 Losartan is an angiotensin II–receptor antagonist that may have similar efficacy but fewer side effects.2 We describe a patient in whom first enalapril and then losartan induced renal insufficiency.

A 46-year-old-man who had had insulin-dependent diabetes mellitus since the age of 6 years underwent combined pancreas and kidney transplantation at the age of 40, but both organs had to be removed because of severe rejection . . . [Full Text of this Article]

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