Addition of silymarin to renin-angiotensin system blockers in normotensive patients with type 2 diabetes mellitus and proteinuria: a prospective randomized trial

Autor: Baris Afsar, Raluca Dumea, Cristina Gavrilovici, Silvia Badarau, Adrian Covic, Mehmet Kanbay, Luminita Voroneanu, Dimitrie Siriopol
Rok vydání: 2017
Předmět:
Nephrology
Male
medicine.medical_specialty
Urology
medicine.medical_treatment
030232 urology & nephrology
Angiotensin-Converting Enzyme Inhibitors
030204 cardiovascular system & hematology
Placebo
Protective Agents
Gastroenterology
law.invention
Diabetic nephropathy
03 medical and health sciences
Angiotensin Receptor Antagonists
0302 clinical medicine
Randomized controlled trial
law
Diabetes mellitus
Internal medicine
medicine
Humans
Diabetic Nephropathies
Renal replacement therapy
Prospective Studies
Antihypertensive Agents
Aged
Proteinuria
business.industry
Type 2 Diabetes Mellitus
Middle Aged
medicine.disease
Surgery
Hospitalization
Renal Replacement Therapy
Survival Rate
Diabetes Mellitus
Type 2
Disease Progression
Kidney Failure
Chronic
Female
medicine.symptom
business
Glomerular Filtration Rate
Silymarin
Zdroj: International urology and nephrology. 49(12)
ISSN: 1573-2584
Popis: In the last decade, despite constant investigation, no current single treatment has been able to decrease the incidence of diabetic nephropathy and to significantly reduce progression of diabetic CKD. Patients with type 2 diabetes mellitus and proteinuria (>0.5 g/day) after a screening and treatment optimization phase were randomly assigned to receive silymarin or placebo. The primary outcome was a composite outcome: mortality, decline of eGFR > 50% and renal replacement therapy. Secondary outcomes were a composite renal outcome (defined as a decline of eGFR ≥ 50% or ESRD) and also to test the effect of silymarin on the change in eGFR and proteinuria. We also assessed the adverse effects (hospitalizations, headache or gastrointestinal symptoms) during the study. One hundred and two patients were included in the study. There were no significant differences between the two study groups regarding the primary and renal outcomes (HR 0.62, 95% CI 0.3–1.2, p = 0.15; HR 0.56, 95% CI 0.26–1.24, p = 0.16, respectively). At study end, eGFR declined significantly in both arms (p
Databáze: OpenAIRE
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