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Reduction of proteinuria by rosiglitazone in non‐diabetic renal disease
Author(s) -
KINCAIDSMITH PRISCILLA,
FAIRLEY KENNETH F,
FARISH STEPHEN,
BEST JAMES D,
PROIETTO JOSEPH
Publication year - 2008
Publication title -
nephrology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.752
H-Index - 61
eISSN - 1440-1797
pISSN - 1320-5358
DOI - 10.1111/j.1440-1797.2007.00903.x
Subject(s) - medicine , rosiglitazone , proteinuria , diabetes mellitus , endocrinology , blood pressure , thiazolidinedione , urology , type 2 diabetes , urinary system , excretion , urine , kidney
SUMMARY: Aim: To investigate the effect of a thiazolidinedione on proteinuria in patients with non‐diabetic renal disease. Methods: In an open‐label randomized cross‐over study, 40 adults with chronic non‐diabetic renal disease completed the study. In a random fashion, one group was treated for 4 months with 4 mg of rosiglitazone first followed by a 4‐month period of standard treatment. The opposite order was used for the second group. Results: Baseline urinary protein excretion rate was 1.45 g/24 h. On rosiglitazone, there was a drop of urinary protein level of 0.24 g/24 h ( P = 0.045). In contrast, there was a trend for proteinuria to increase during the control period (0.12 g/24 h, P = 0.18). The urine protein level on rosiglitazone was lower than on usual treatment (0.36 g/24 h, P = 0.002, 95% CI 0.15–0.58). There was a similar beneficial effect on systolic blood pressure which was reduced by rosiglitazone by 7.8 mmHg ( P = 0.006, 95% CI 2.6–13.1). Although average fasting glucose was only 5.8 mmol/L, there was a significant Spearman correlation between fasting glucose and a reduction in urinary protein levels ( r = 0.34, P = 0.045). Conclusion: It is concluded that thiazolidinediones may have a role in the management of non‐diabetic proteinuria of various aetiologies. In this study the average body mass index was 28.9 kg/m 2 . It will be important to repeat these studies in non‐overweight subjects with non‐diabetic proteinuria and in addition to trial maximal therapeutic doses of the thiazolidenedione.