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Abstract                 Volume:4  Issue-4  Year-2016          Original Research Articles


Online ISSN : 2347 - 3215
Issues : 12 per year
Publisher : Excellent Publishers
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Effect of hydrochlorothiazide and spironolactone on reducing proteinuria among patients with diabetic nephropathy treated by angiotensin converting enzyme inhibitors
Hamid Noshad1*, Taher Manzary2 and Amir Teimouri-Dereshki3
1Professor of Nephrology, Chronic Kidney Disease Research Center, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran
2Resident of Internal Medicine, Imam Reza Hospital, Department of Internal Medicine, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran
3Students, Research Committee, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran
*Corresponding author
Abstract:

style="text-align: justify;">Diabetic nephropathy is one of the leading causes of the end stage renal disease (ESRD) in all over the world. Overriding of renin-angiotensin-aldosterone system (RAAS) is considered as one of the important mechanisms of renal damage among diabetic patients. Treatment with RAAS inhibitor drugs, angiotensin converting enzyme inhibitors and angiotensin receptor blockers (ACEIs and ARBs) reduces the rate of renal involvement and consequently progression of diabetic nephropathy toward ESRD. The aim of this study was comparison of antiproteinuric effects of Hydrochlorothiazide (HCTZ) with Spironolactone in patients with diabetic nephropathy who were treated with ACEIs. In a randomized clinical trial in Sheikh-ol-raies university clinic, 90 hypertensive diabetic patients who were receiving Enalapril because of diabetic nephropathy underwent combination treatment with HCTZ and Spironolactone as two different groups. Urine albumin decreased from 1342±927 mg/day at the beginning of the study, to 1093±814 mg/day among HCTZ group, and from 1183±916 mg/day to 955±786 mg/day in spironolactone group. but these differences was not statistically significant (P=0.9). Furthermore systolic blood pressure (SBP) decreased from 145±15 to 135±16 mmHg in HCTZ group and from 151±12 to 145±16 mmHg among Spironolactone group. In HCTZ group SBP decreased more significantly (P=0.022). Among Spironolactone receivers, serum potassium increased significantly. This difference was statistically significant (P =0.007). In our study, there were no statistically significant differences in decreasing albuminuria or reducing blood pressure between these two groups but, because HCTZ did not cause any hyperkalemia, combination of ACEIs with HCTZ is preferable.

Keywords: Diabetic nephropathy, Proteinuria, Hydrochlorothiazide, Spironolactone
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How to cite this article:

style="text-align: justify;">Hamid Noshad, Taher Manzary and Amir Teimouri-Dereshki. 2016. Effect of hydrochlorothiazide and spironolactone on reducing proteinuria among patients with diabetic nephropathy treated by angiotensin converting enzyme inhibitors.Int.J.Curr.Res.Aca.Rev. 4(4): 225-233
doi: http://dx.doi.org/10.20546/ijcrar.2016.404.028