بررسي اثر داروي پيوگليتازون بر پروتئينوري در بيماران كليوي غير ديابتي: يك كارآزمايي درماني خود شاهد

Effect of Pioglitazone on Proteinuria in Non-Diabetic Renal Patients: A Self-Control Clinical Trial

Background: Proteinuria has independent deleterious effects on the progression of chronic renal disease. The aim of this study was to determine effect of pioglitazone on proteinuria in patients with non-diabetic renal disease. Methods: This was a self-controlled clinical trial study conducted in Al-Zahara Hospital and few pri¬vate clinics of nephrology in Isfahan. Forty four non-diabetic patients aged 18 and over, who had renal disease and stable proteinuria over 0.5 g in 24 h and body mass index (BMI) lower than 30 kg/m2, were enrolled in the study. Patients were treated by 15 mg of pioglitazone for 4 months. The primary end point was urine protein excretion, measured prior to the study, at the end of 2 and 4 months during treatment as well as 2 months after cessation of pioglitazone. Secondary end points included systolic blood pressure, creatinine, ALT, AST, FBS, BUN and GFR levels. Findings: Mean urine protein excretion was 1088.6 ± 775.6 mg/24 h before treatment; therefore mean urine protein excretion at the end of 4th month was 433.9 ± 406.2 mg/24 h (P<0.001, CI95%: 0.49-0.82). There was no significant trend for systolic blood pressure, creatinine, ALT, AST, FBS, BUN and GFR levels to increase or decrease during the follow-up period (P> 0.01). Conclusion: Considering complications of proteinuria followed by gradual kidney malfunction based on findings of present study, pioglitazone could significantly decrease proteinuria in patients with non- diabetic kidney diseases. Key words: Proteinuria, Pioglitazone, Non-diabetic renal disease, Hypoglycemic agent.