Ruggenenti P, et al. - In people with type 2 diabetes and overt nephropathy, researchers ascertained if angiotensin-converting enzyme (ACE) inhibitor and angiotensin II receptor blocker (ARB) combination therapy was more nephroprotective than ACE inhibitor or ARB monotherapy. For this investigation, 103 patients with type 2 diabetes (aged >40 years) with serum creatinine levels 159 to 309 μmol/L, spot morning urinary albumin–creatinine ratio > 1000 mg/g (or > 500 mg/g in those on ACE inhibitor or ARB therapy at inclusion) were stratified by centre and randomized to 4.5-year treatment with valsartan 320 mg/d (n = 36), benazepril 20 mg/d (n = 34) or halved doses of both medications (n = 33). According to this prospective, randomized, open, blind-endpoint phase III trial sponsored by the Italian Drug Agency, valsartan (320 mg/d) safely postponed end-stage renal disease in people with type 2 diabetes with nephropathy more effectively than benazepril (20 mg/d) or half the doses of both drugs. Adverse events have been similarly distributed among the groups.