Effect of Dual Blockade of Renin-Angiotensin Aldosterone System on Proteinuria in Patients with Diabetic Nephropathy and Advanced Azotemia
| Autor: | Mustafa Keles, Ramazan Cetinkaya, Ali Riza Odabas, Abdullah Uyanik, Ilyas Capoglu, Hatice Odabas |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2015 |
| Předmět: |
medicine.medical_specialty
Angiotensin receptor Creatinine Aldosterone Proteinuria business.industry Urology Pharmaceutical Science urologic and male genital diseases medicine.disease female genital diseases and pregnancy complications Diabetic nephropathy chemistry.chemical_compound Endocrinology Irbesartan chemistry Internal medicine medicine Pharmacology (medical) Azotemia Enalapril medicine.symptom Angiotensin-converting enzyme inhibitor Angiotensin receptor blocker Diabetic nephropathy Azotemia Proteinuria Aldosterone Renin Blood pressure business medicine.drug |
| Zdroj: | Tropical Journal of Pharmaceutical Research; Vol 14, No 10 (2015); 1885-1891 |
| ISSN: | 1596-5996 1596-9827 |
| Popis: | Purpose : To investigate the dual effect of angiotensin blockade by irbesartan and enalapril on proteinuria in diabetic patients with azotemia. Methods : Patients with diabetes of > 5 years duration, proteinuria at a nephrotic level and serum creatinine > 1.5 mg/dL were enrolled in the study. Forty-five enrolled patients were divided into three groups, those receiving enalapril , irbesartan, or enalapril plus irbesartan, respectively, over a period of 24 weeks. Urinary protein excretion and serum level of albumin, creatinine, potassium were measured before and after treatment Results : In patients receiving enalapril, irbesartan, and both drugs concomitantly, mean urinary protein excretion level decreased significantly at the end of 6 months from 6.46 ± 4.66 to 3.36 ± 1.60, 5.89 ± 5.34 to 3.22 ± 1.72 and 5.99 ± 3.77 to 2.10 ± 2.22 g/day, respectively (p = 0.001). Decrease in proteinuria in the group receiving the combined therapy was more significant than the other two groups (p = 0.025). During the period of therapy, serum albumin increased and mean arterial pressure decreased significantly (p = 0.02 and p = 0.002, respectively) but serum creatinine and potassium and creatinine clearance values showed insignificant increases (p = 0.28 and p = 0.57, respectively). Conclusion : The combined use of enalapril and irbesartan, in patients with diabetic nephropathy associated with azotemia, is more effective in decreasing proteinuria without causing any substantial increase in serum potassium levels. The combined use of these two drugs shows a more pronounced anti-proteinuric effect. Keywords : Angiotensin-converting enzyme inhibitor, Angiotensin receptor blocker, Diabetic nephropathy, Azotemia, Proteinuria, Aldosterone, Renin, Blood pressure |
| Databáze: | OpenAIRE |
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