Renoprotective Effect of Aliskiren Monotherapy and Aliskiren-Pentoxifylline Combination vs Other Renin-Angiotensin System Inhibitors in Hypertensive-Diabetic Type 2 Patients with Diabetic Nephropathy (Gaza Strip)

Taha, Mohammed (2012) Renoprotective Effect of Aliskiren Monotherapy and Aliskiren-Pentoxifylline Combination vs Other Renin-Angiotensin System Inhibitors in Hypertensive-Diabetic Type 2 Patients with Diabetic Nephropathy (Gaza Strip). Masters thesis, Al Azhar University Gaza.

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Abstract

Diabetic nephropathy (DN) is one of the most serious complications of diabetes mellitus (DM) and is the leading cause of end-stage renal disease (ESRD). Excessive activity of the renin-angiotensin system (RAS) plays a vital role in initiation and progression of DN. The purpose of this study was to evaluate the renoprotective effect of aliskiren (direct renin inhibitor) monotherapy and combination of aliskiren plus pentoxifylline (xanthine derivative), and compare it with enalapril and valsartan (RAS inhibitors) in hypertensive-diabetic type 2 patients with DN among patients in Gaza Strip. To achieve this purpose, eighty hypertensive-diabetic type 2 patients with microalbuminurea (20-200 μg/min or 30-300 mg/24h) were selected from UNRWA and private clinics in Gaza Strip and divided into four groups. The first group (n=20) was treated with enalapril (10-20 mg/day), the second one (n=20) was treated with valsartan (160 mg/day), the third group (n=20) was treated with aliskiren (150 mg/day), whereas the fourth one (n=20) was treated with aliskiren-pentoxifylline combination (150, 400 mg/day), then 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 9 months of treatment. The results showed a significant reduction in UAE rate among patients who used aliskiren and aliskiren-pentoxifylline combination after 6 and 9 months of treatment, where the reduction in both groups was more pronounced at 9 months of treatment. In the valsartan treated group, the reduction in UAE rate was significant after 9 months of treatment, while in the enalapril treated group, no significant reduction in UAE rate was seen throughout the study period (9 months). In addition, the results also showed a significant reduction in serum creatinine level after 6 and 9 months of aliskiren-pentoxifylline combination treatment, whereas the decrease became significant after 9 months of aliskiren treatment. On the other hand, no significant reduction in serum creatinine level among patients who used enalapril or valsartan during the study period (9 months). The study revealed that aliskiren monotherapy and aliskiren-pentoxifylline combination had more pronounced renoprotective effect than enalapril and valsartan among hypertensive-diabetic type 2 patients with DN. Keywords: Diabetic Nephropathy, Aliskiren, Aliskiren-Pentoxifylline Combination, Valsartan, Enalapril, Urinary Albumin Excretion (UAE) Rate, Serum Creatinine Level, Renoprotective Effect.

Item Type: Thesis (Masters)
Subjects: Q Science > Q Science (General)
Depositing User: أ. طارق زياد عبد حنونة
Date Deposited: 18 Aug 2020 09:04
Last Modified: 18 Aug 2020 09:04
URI: http://scholar.alaqsa.edu.ps/id/eprint/2112

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