Kim MK, Ko SH, Baek KH, Ahn YB, Yoon KH, Kang MI, Lee KW, Song KH.
Department of Internal Medicine, The Catholic University of Korea College of Medicine, Seoul, Korea.
BACKGROUND/AIMS: Thiazolidinediones reduce urinary albumin excretion and may prevent the development of renal injury. We evaluated the long-term effects of rosiglitazone on the progression of renal dysfunction in patients with type 2 diabetes mellitus. METHODS: We enrolled patients with type 2 diabetes mellitus who initially had normal or mildly impaired renal function, defined as an estimated glomerular filtration rate (eGFR) of 60-120 mL/min per 1.73 m2, and normoalbuminuria. Patients were divided into two groups according to their use of rosiglitazone during 3 years of follow-up: those treated with rosiglitazone (rosiglitazone group, n=52) and those treated without rosiglitazone (control group, n=85). Progression of renal dysfunction was defined as a decrease in eGFR of >or=9 mL/min per 1.73 m2 after 3 years. RESULTS: A greater difference was observed in the decrease in eGFR between the rosiglitazone and control groups after 3 years (3.8+/-9.9 vs. 12.6+/-10.5 mL/min per 1.73 m2, p<0.001). Seventeen of 52 (32.7%) patients in the rosiglitazone group and 53 of 85 (62.3%) patients in the control group showed progression of renal dysfunction (p=0.001). The progressors had a longer duration of diabetes (6.7+/-5.9 vs. 3.9+/-4.1 years, p=0.002), higher HbA1c levels (7.4+/-1.8 vs. 6.8+/-1.3%, p=0.023), and less frequent use of rosiglitazone (24.2 vs. 52.2%, p<0.001) compared to non-progressors. Multiple logistic regression analysis revealed that the use of rosiglitazone was a significant and independent predictor of the progression of renal dysfunction. CONCLUSIONS: This study suggests that rosiglitazone treatment slows the progressive deterioration of renal function in patients with type 2 diabetes.
PMID: 19721859
| < Prev | Next > |
|---|
