Effect of Thiazolidinedione Treatment on Proteinuria and Renal Hemodynamic in Type 2 Diabetic Patients with Overt Nephropathy
Hormone and Metabolic Research, 06/22/2012
Clinical Article
Pistrosch F et al. – Rosiglitazone (RSG) treatment was generally well tolerated and the major adverse event – development of edema – could be controlled by dose adjustment of the study drug and diuretic agents. The authors demonstrated a possible renoprotective effect of RSG in patients with advanced diabetic nephropathy.
Methods- A total of 28 type 2 diabetic patients (4 women and 24 men, mean age 66.1±9.1 years) with urinary albumin excretion >300 mg/24 h and an estimated glomerular filtration rate (GFR) <60 ml/min were included into this prospective double blind trial to receive either rosiglitazone (RSG) 4 mg b.i.d or matching placebo (PLC) for 52 weeks in addition to their concomitant antidiabetic background therapy.
- At baseline and after 26 and 52 weeks, renal plasma flow (RPF) and GFR were determined before and after blockade of nitric oxide (NO) by intravenous administration of N-monomethyl-l-arginine acetate.
- RSG treatment resulted in a significant reduction of proteinuria (2.4±1.1; 1.2±0.6; 1.5±0.7 g/d at baseline, 26 weeks and 52 weeks; respectively, p<0.05) whereas PLC did not influence proteinuria (1.6±0.6; 1.6±0.8; 1.7±0.8 g/d).
- GFR and RPF did not change significantly during the study, however, RSG improved the intrarenal NO bioavailability.
- RSG treatment was generally well tolerated and the major adverse event - development of edema - could be controlled by dose adjustment of the study drug and diuretic agents.
