Endocrine Abstracts

Objective: The objective of this study was to determine the efficacy of combination therapy with pioglitazone and losartan in delaying the progression of chronic renal failure in subjects with type 2 diabetic nephropathy.

Methods: A randomized, controlled trial was conducted in 60 patients with type 2 diabetic nephropathy. 30 patients received the combination treatment with pioglitazone 30 mg daily and losartan 100 mg daily, and 30 patients received losartan 100 mg daily as control. Patients were assessed at baseline and visits were scheduled every three months for determination of 24 hours urinary protein excretion, endo-genous creatinine clearance rate (Ccr). Glomerular filtration rate (GFR) was measured by ^99mTc diethyl-enetriamine pentaacetic (DTPA) renogram at baseline and at the end of one-year treatment period.

Results: Ccr in pioglizone group decreased slowly compared with control group. After 12 months of treatment, changes of GFR in pioglitazone group were statistically significant compared with groups with losartan both at CKD stage 3 and stage 4. Proteinuria significantly decreased over 6 and 12 months of treatment in both groups compared with the baseline and the efficiency of pioglitazone treatment was better than that of losartan alone over 6 and 12 months. Fasting blood glucose was lowered in both groups over 3–12 months, and dual treatment induced an additional reduction in fasting blood glucose levels after 12 months treatment.

Conclusions: Combination therapy with pioglitazone and losartan provides additional renoprotection in subjects with type 2 diabetic nephropathy, and it was generally well tolerated.