Study of comparative evaluation of Atorvastatin and Salicinol (salacia roxburghii) on GFR and carotid intima media thickness in diabetic and non-diabetic CKD patients with hypertension

Abstract

Background: Most of the newer concepts in Nephrology developed in the 19th and 20th centuries. Progression of renal failure is an area of Nephrology where our understanding has improved appreciably in the last century, but still, our knowledge is like a drop in the ocean. We have ample evidence that the progression of renal failure can be slowed down, but we still need more definite information on whether established renal failure can be reversed. This pilot clinical study was planned to explore the therapeutic potential of salicinol in retardation of chronic kidney disease progression and anti-atherosclerotic property by looking for if a reduction in CIMT is possible. Objectives: To study of comparative evaluation of atorvastatin and salicinol (salacia roxburghii) on GFR and CIMT in diabetic and non-diabetic CKD patients with hypertension. Methods: The present study was conducted in the Department of Medicine, Institute of Medical Sciences, Banaras Hindu University, Varanasi. Eighty patients of mild to moderate stable chronic renal failure with hypertension attending Nephrology OPD or admitted in the Nephrology ward from May 2014 to June 2015 were included in the study. Patient with acute MI, congestive heart failure, unstable angina, myopathy. Subsequently, patients were allocated to one of the two groups, the first group consisted of Diabetic patient treated with atorvastatin salicinol, and second group was of non-diabetic treated patients. Results: Among total patients included in study, 35 were non-diabetic, and 45 were diabetic. Mean serum creatinine at baseline study in the diabetic and non-diabetic group were 4.3 ± 2.0, and 5.0 ± 1.6, and changes were statistically significant intragroup. Mean CIMT in diabetic and non-diabetic at baseline were 0.92 ± 0.07 and 0.90±0.07, and when comparing both changes were statistically significant at three months and 6 months suggesting CIMT regression more in diabetic groups compared to non-diabetics. Mean GFR in a diabetic and non-diabetic group at baseline was 23.4 ± 15.6 and 17.8±13.7. On intergroup comparison, changes were statistically significant at 3 months and at 6-month. Conclusion: The male to female ratio was 2:1. Age of the patient ranged from 20years onwards. No significant effect of the drug was seen on 24hrs urinary protein, blood pressure, hemoglobin and GFR. On comparison of non-diabetic and diabetic significant decreases (0.05) in GFR were observed at the end of the study. On comparison of non-diabetic and diabetic highly significant decrease (0.001) in CIMT were observed at three months and at the end of the study.