The effect of direct renin inhibition alone and in combination with ACE inhibition on endothelial function, arterial stiffness, and renal function in type 1 diabetes.

Changes in these renal hemodynamic parameters were all highly significant after the addition of ramipril, and the decline in RVR was exaggerated compared with the response to aliskiren monotherapy (repeated-measures ANOVA, P < 0.001; Table 3 ).

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For renal hemodynamic function during clamped hyperglycemia, aliskiren monotherapy was associated with an increase in ERPF, whereas changes in RBF and RVR failed to reach significance.

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In response to aliskiren monotherapy during clamped euglycemia, aldosterone levels tended to decrease, but this change did not reach statistical significance ( Table 2 ).

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