Early renin-angiotensin system intervention is more beneficial than late intervention in delaying end-stage renal disease in patients with type 2 diabetes

Aims To develop and validate a model to simulate progression of diabetic kidney disease (DKD) from early onset until end‐stage renal disease (ESRD), and to assess the effect of renin‐angiotensin system (RAS) intervention in early, intermediate and advanced stages of DKD. Methods We used data from the BENEDICT, IRMA‐2, RENAAL and IDNT trials that assessed effects of RAS intervention in patients with type 2 diabetes. We built a model with discrete disease stages based on albuminuria and estimated glomerular filtration rate (eGFR). Using survival analyses, we assessed the effect of RAS intervention on delaying ESRD in early [eGFR>60 ml/min/1.73 m2 and albumin:creatinine ratio (ACR)