Renal function, glycemic control and perindopril in diabetic patients

Area of Science:

• Nephrology
• Cardiology
• Endocrinology

Background:

• Hypertension and diabetes are leading causes of chronic kidney disease.
• Diabetic nephropathy is characterized by albuminuria and is a major complication of diabetes.
• Angiotensin-converting enzyme (ACE) inhibitors are used to manage hypertension and protect renal function.

Purpose of the Study:

• To evaluate the effect of perindopril on renal function, albuminuria, and glycemic control in diabetic patients with hypertension.
• To assess the efficacy of perindopril in reducing albuminuria in different stages of kidney involvement.

Main Methods:

• A 9-month study involving 40 insulin-treated diabetic patients with mild-to-moderate hypertension.
• Patients were categorized into three groups based on baseline albuminuria levels (normal, microalbuminuria, macroproteinuria).
• Perindopril (4 or 8 mg daily) was administered after a 1-month placebo period, with follow-up at 1, 3, and 9 months.

Main Results:

• Perindopril normalized diastolic blood pressure in 80% of patients within 3 months.
• Significant reduction in microalbuminuria was observed in Group II patients (from 59 ± 13 to 32 ± 6 mg/24 hr) after 1 month, sustained at 9 months.
• No significant changes in albumin excretion rate were noted in groups with normal or macroproteinuria, and creatinine clearance and glycemic control remained stable.

Conclusions:

• Perindopril is effective in normalizing blood pressure in hypertensive diabetic patients.
• Perindopril demonstrates a significant and sustained reduction in microalbuminuria, indicating potential renoprotective effects in patients at risk of diabetic nephropathy.
• The treatment did not adversely affect glycemic control or overall renal function (creatinine clearance).