Effect of diacerein on renal function and inflammatory cytokines in participants with type 2 diabetes mellitus and chronic kidney disease: A randomized controlled trial

Autor: Michael Everton Andrades, Hugo Roberto Kurtz Lisboa, Glaucia Sarturi Tres, Leila Beltrami Moreira, Fabiana Piovesan, Sandra C. Fuchs
Rok vydání: 2017
Předmět:
Male
0301 basic medicine
Physiology
lcsh:Medicine
Blood Pressure
Anthraquinones
Type 2 diabetes
030204 cardiovascular system & hematology
Pathology and Laboratory Medicine
Kidney
Vascular Medicine
Biochemistry
Gastroenterology
Placebos
chemistry.chemical_compound
Endocrinology
0302 clinical medicine
Drug Metabolism
Glucose Metabolism
Chronic Kidney Disease
Medicine and Health Sciences
Medicine
lcsh:Science
Immune Response
Multidisciplinary
Middle Aged
Type 2 Diabetes
Nephrology
Research Design
Carbohydrate Metabolism
Cytokines
Female
Inflammation Mediators
Research Article
Glomerular Filtration Rate
medicine.drug
medicine.medical_specialty
Endocrine Disorders
Clinical Research Design
Immunology
Renal function
Research and Analysis Methods
03 medical and health sciences
Signs and Symptoms
Diagnostic Medicine
Internal medicine
Diabetes mellitus
Diabetes Mellitus
Humans
Pharmacokinetics
Diacerein
Aged
Pharmacology
Inflammation
Renal Physiology
business.industry
lcsh:R
Biology and Life Sciences
Type 2 Diabetes Mellitus
medicine.disease
Metabolism
030104 developmental biology
Blood pressure
Diabetes Mellitus
Type 2
chemistry
Metabolic Disorders
Kidney Failure
Chronic
lcsh:Q
Adverse Events
Glycated hemoglobin
business
Kidney disease
Zdroj: PLoS ONE
PLoS ONE, Vol 12, Iss 10, p e0186554 (2017)
ISSN: 1932-6203
DOI: 10.1371/journal.pone.0186554
Popis: Diacerein seems to improve metabolic control and reduce inflammatory marker levels in individuals with type 2 diabetes mellitus (Type 2 DM), but for participants with chronic kidney disease (CKD) its effect is unknown. This study aimed to evaluate the effect of diacerein vs. placebo on urinary albumin/creatinine ratio (ACR), glomerular filtration rate (GFR), and inflammatory cytokines in type 2 DM participants with CKD. Blood pressure (BP) and metabolic control were secondary outcomes. This randomized, placebo-controlled, parallel trial of adjuvant treatment of type 2 DM with diacerein enrolled seventy-two participants with CKD, aged 30-80 years, with glycated hemoglobin levels from 53-97 mmol/mol (7.0-11.0%), receiving angiotensin-converting enzyme inhibitors or angiotensin receptor blockers and antidiabetic agents. Participants randomized to diacerein or placebo were followed-up up to 90 days. Both groups had a marked reduction in ACR, but there was no effect on glomerular filtration rate. While the diacerein group had reduced TNF-α levels at the 75th percentile with a borderline significance (P = 0.05), there were no changes in the IL levels at the 75th percentile. Diacerein prevented the increase in blood glucose to the level observed in the placebo group (P = 0.04), improving metabolic control by 74%, reducing 24-hour diastolic BP, nighttime systolic and diastolic BP compared to the placebo group. In conclusion, among patients with type 2 DM and CKD, diacerein does not have an effect on ACR or GFR, but slows metabolic control deterioration and is associated with lower nighttime systolic and diastolic blood pressure. Trial registration Brazilian Clinical Trials Registry (Registro Brasileiro de Ensaios Clinicos; ReBeC) U1111-1156-0255.
Databáze: OpenAIRE
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