Abstract
BackgroundDiabetic nephropathy (DN) is one of the most serious complications of diabetes mellitus. Excessive activity of renin−angiotensin system plays a vital role in initiation and progression of DN. In addition, many studies have shown that inflammation plays a significant role in DN development. PurposeThis study was performed to evaluate the renoprotective effect of aliskiren (direct renin inhibitor) monotherapy and combination of aliskiren plus pentoxifylline (xanthine derivative) in hypertensive-diabetic type 2 patients with DN among patients in Gaza Strip. MethodsForty hypertensive-diabetic type 2 patients with microalbuminurea (20–200μg/min or 30–300mg/24h) were selected from UNRWA and private clinics in Gaza Strip and divided into two groups. The first group (n=20) was treated with aliskiren (150mg/day), whereas the second group (n=20) was treated with aliskiren−pentoxifylline combination (150, 400mg/day). All patients were followed-up for nine months by measuring serum creatinine level and urinary albumin excretion (UAE) rate before and at 3, 6 and 9months of treatment. ResultsThe results showed a significant reduction (P<0.05) in UAE rate among patients who used aliskiren and aliskiren−pentoxifylline combination after 6 and 9months of treatment, where the reduction in both groups was more pronounced at 9months of treatment. Moreover, the results also showed a significant reduction (P<0.05) in serum creatinine level after 6 and 9months of aliskiren−pentoxifylline combination treatment, whereas the decrease became significant (P<0.05) only after 9months of aliskiren treatment. ConclusionAliskiren monotherapy and aliskiren−pentoxifylline combination improved kidney function among hypertensive-diabetic type 2 patients with DN, however, aliskiren−pentoxifylline combination had a better renoprotective effect.
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