Whether this
discrepancy indicates that albuminuria is not an
appropriate surrogate or whether it is appropriate
but adverse effects of combination therapy
offset any benefit is unknown. In addition, our
results illustrate that studies showing a treatment
benefit with respect to intermediate outcomes
may have insufficient power to identify a safety
signal that can be detected only in larger, longterm
studies. In conclusion, the results of our study show
that the use of combination therapy with an ACE
inhibitor and an ARB in patients with proteinuric
diabetic kidney disease does not provide an
overall clinical benefit