Renoprotection provided by losartan in combination with pioglitazone is superior to renoprotection provided by losartan alone in patients with type 2 diabetic nephropathy.

Author(s): Jin HM, Pan Y

Affiliation(s): Division of Nephrology, No. 3 People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, PR China. hmjgli@yahoo.com.cn <hmjgli@yahoo.com.cn>

Publication date & source: 2007, Kidney Blood Press Res., 30(4):203-211. Epub 2007 Jun 15.

Publication type:

AIM: This study was performed to ascertain whether losartan combined with pioglitazone is superior to losartan alone in delaying the progression of chronic renal failure in patients with type 2 diabetic nephropathy. METHODS: Sixty patients with type 2 diabetic nephropathy (stage 3 or 4 chronic kidney disease) were enrolled in a randomized, controlled trial. Thirty patients received losartan (100 mg/day) and pioglitazone (30 mg/day), and 30 patients received losartan only (100 mg/day). The patients were assessed at baseline and at 3-month intervals for 24-hour urinary protein excretion, serum creatinine, creatinine clearance, and fasting blood glucose values. The glomerular filtration rate was measured by means of a (99m)Tc-diethylenetriamine penta-acetic renogram at baseline and after 12 months. RESULTS: As compared with therapy with losartan alone, the losartan-pioglitazone combination therapy resulted in significantly lower serum creatinine and fasting glucose values at 12 months and in significantly lower degrees of proteinuria at 6 and 12 months. The declines in creatinine clearance and glomerular filtration rate below baseline measurements at stages 3 and 4 of chronic kidney disease were significantly slower for the losartan-pioglitazone group as compared with the losartan-only group. CONCLUSIONS: Renoprotection conferred by losartan combined with pioglitazone is superior to that conferred by losartan alone in subjects with type 2 diabetic nephropathy. The combination is generally well tolerated. Copyright 2007 S. Karger AG, Basel.