COMPARISON OF ANGIOTENSIN RECEPTOR BLOCKER ALONE AND IN COMBINATION WITH VITAMIN D ANALOGUE IN REDUCING PROTEINURIA IN DIABETIC NEPHROPATHY PATIENTS
Keywords:Diabetic nephropathy, Proteinuria, Telmisartan, Calcitriol
Objective: This study was designed to determine the synergistic effect of vitamin D analog added to angiotensin receptor blocker in reducing proteinuria in diabetic nephropathy patients.
Methods: A randomized, open label, prospective, parallel assignment, comparative study included 50 patients with diabetic nephropathy who had a spot protein to creatinine ratio (PCR) of 100 - 1000 mg/g creatinine. Patients were randomized to receive treatment with either telmisartan 40 mg or calcitriol 0.25 mcg for a period of 12 weeks. The primary end point was the difference in the spot urinary PCR between the groups at 12 weeks. The secondary endpoints are change in Blood Pressure (BP), serum creatinine and glomerular filtration rate (GFR).
Results: The primary end point of the study was reduced by 43.2% with telmisartan and 77.049% with telmisartan and calcitriol treatment (P= 0.0001) during 12 week periods. In the secondary end points, there were no significant differences.
Conclusion: Hence, this study concludes that treatment with both calcitriol and telmisartan offers synergistic renoprotection.
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