Penggunaan obat antihipertensi dari angiotensin converting enzyme inhibitor (ACEI) dan angiotensin receptor blocker (ARB) kelompok memiliki efek renoprotektif dan direkomendasikan pada pasien dengan diabetes mellitus dengan hipertensi di Indonesia. Penelitian ini dilakukan untuk menentukan efektivitas kelompok ACEI atau ARB pada fungsi ginjal, morbiditas, dan efek samping dari peningkatan nilai kalium. Penelitian ini dilakukan pada 123 pasien dengan metode kohort prospektif-retrospektif menggunakan kuesioner yang divalidasi, pengumpulan data pada catatan medis, dan pengukuran laboratorium di RSUPN Dr. Ciptomangunkusumo pada November 2018 hingga April 2019. Setelah 3 bulan pengamatan, tidak ada perubahan dalam parameter dalam kelompok ACEI kecuali untuk peningkatan BMI (p = 0,046), sedangkan pada kelompok ARB tidak ada perubahan dalam parameter kecuali untuk penurunan LDL (p = 0,016) dan penurunan HDL (p = 0,004). Tidak ada perbedaan pada kedua kelompok dalam hal perubahan nilai Urine Albumin Creatinine Ratio (UACR) (p = 0,675), eLFG (p = 0,062), morbiditas (p = 0,309), dan nilai kalium (p = 0,166 ) 3 bulan. Pengaruh BMI> 25 OR = 2.780 (95% CI = 1.181-6.544), durasi ACEI / ARB> 6 bulan ATAU 3.705 (95% CI = 1.164-11.795) dan UACR 30-300 pada awal penelitian 3.158 ( 95% CI = 1.233 -8.089) melawan UACR. Pengaruh jenis kelamin laki-laki OR = 3.674 (95% CI = 1.544-8.741), LDL OR = 3.168 (95% CI = 1.246-8.057), trigliserida 0 bulan OR = 3.024 (95% CI = 1.274-7.175), dan tekanan darah sistolik OR = 3.317 (95% CI = 1.255-8.769) terhadap eLFG. Pengaruh usia ≤ 60 tahun OR = 3.040 (95% CI = 1.378-6.710) dan kalium pada awal penelitian ≤ 5 mmol / L OR = 4.178 (95% CI = 1.791-9.748) pada peningkatan kalium. Peningkatan delta LDL OR = 10.072 (95% CI = 1.618-62.709), HDL 40-60 mg / dL OR yang dikontrol 0 bulan = 14.741 (95% CI = 3.074-70.680), peningkatan delta trigliserida OR = 6.390 (95% CI = 957 CI 1,215-33,615) dan total kolesterol yang dikontrol OR = 5,718 (95% CI = 1,570-20,828) terhadap morbiditas. Penggunaan ARB memiliki nilai eLFG signifikan yang meningkat atau tetap (p = 0,042) (OR = 2,370, 95% CI = 1,031-5,4449) setelah mengendalikan variabel pengganggu jenis kelamin, LDL, trigliserida, dan tekanan darah sistolik. Kesimpulan dari penelitian ini adalah bahwa penggunaan ARB meningkatkan eLFG atau mempertahankan eLFG dibandingkan dengan ACEI dengan beberapa variabel terkontrol.

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The use of antihypertensive drugs of the angiotensin converting enzyme inhibitor (ACEI) and angiotensin receptor blocker (ARB) groups has a renoprotective effect and is recommended in patients with diabetes mellitus with hypertension in Indonesia. The study was conducted to determine the effectiveness of the ACEI or ARB group on kidney function, morbidity, and side effects of increasing potassium values. The study was conducted on 123 patients with a retrospective-prospective cohort method using a validated questionnaire, data collection on medical records, and laboratory measurements at RSUPN Dr. Ciptomangunkusumo in November 2018 until April 2019. After 3 months of observation, there were no changes in parameters in the ACEI group except for an increase in BMI (p = 0.046), whereas in the ARB group there were no changes in parameters except for a decrease in LDL (p = 0.016) and a decrease HDL (p = 0.004). There were no differences in the two groups in terms of changes in the value of Urine Albumin Creatinine Ratio (UACR) (p = 0.675), eLFG (p = 0.062), morbidity (p = 0.309), and potassium value (p = 0.166) 3 months. Effect of BMI> 25 OR = 2,780 (95% CI = 1,181-6,544), duration of ACEI / ARB> 6 months OR 3,705 (95% CI = 1,164-11,795) and UACR 30-300 at the start of the study 3,158 (95% CI = 1,233 -8,089) against UACR. Effect of male sex OR = 3,674 (95% CI = 1,544-8,741), LDL OR = 3,168 (95% CI = 1,246-8,057), triglyceride 0 months OR = 3,024 (95% CI = 1,274-7,175), and blood pressure systolic OR = 3,317 (95% CI = 1,255-8,769) against eLFG. Effect of age ≤ 60 years OR = 3,040 (95% CI = 1,378-6,710) and potassium at the start of the study ≤ 5 mmol/L OR = 4,178 (95% CI = 1,791-9,748) on the increase in potassium. Increased LDL delta OR = 10,072 (95% CI = 1,618-62,709), 0 month controlled HDL 40-60 mg/dL OR = 14,741 (95% CI = 3,074-70,680), increase in triglyceride delta OR = 6,390 (95% CI = 957 CI 1,215-33,615) and total cholesterol controlled OR = 5,718 (95% CI = 1,570-20,828) to morbidity. The use of ARB had a significant value of eLFG that increased or remained (p = 0.042) (OR = 2.370 95% CI = 1.031-5.4449) after controlling for confounding variables of gender, LDL, triglycerides, and systolic blood pressure. The conclusion of this study is that the use of ARB either increases eLFG or maintains eLFG compared to ACEI with several controlled variables.