ROLE OF TELMISARTAN IN DIABETIC NEPHROPATHY A NOVEL TREATMENT AVENUE

Dr Manash Das, Dr Md Anfas Nusrat Pasha, Dr Mriganka Baruah, Dr Mukesh Gupta, Dr Navneet Maini

Abstract


Globally, the prevalence of diabetes mellitus is continuously escalating. The complications of chronic diabetes mellitus include retinopathy, neuropathy, nephropathy, cardiomyopathy, and vasculopathy. Diabetes mellitus is the leading cause of renal failure and approximately 20-30% of all diabetic subjects develop evidence of diabetic nephropathy manifesting from microalbuminuria to macroalbuminuria and renal failure. Nephropathy is one of the major complications of uncontrolled diabetes mellitus. The renal pathologic alterations of diabetic nephropathy are associated with glomerular basement membrane thickening, mesangial cell expansion, glomerulosclerosis, interstitial fibrosis, podocyte loss, and tubular atrophy. These renal alterations during diabetic nephropathy could result in albuminuria, a decrease in glomerular filtration rate (GFR) and an increase in serum creatinine and urea nitrogen levels1. The renin-angiotensin system (RAS) plays a pivotal role in the pathogenesis of diabetic nephropathy2.

Keywords


TELMISARTAN, NEPHROPATHY, glomerular ltration rate (GFR)

Full Text:

PDF

References


Balakumar P, K. Bishnoi H, Mahadevan N. Telmisartan in the Management of Diabetic Nephropathy: A Contemporary View. Curr Diabetes Rev. 2012;8(3):183-190. doi:10.2174/157339912800563972

Fukami K, Yamagishi S. An Overview on Diabetic Nephropathy. Nutr Ther Interv Diabetes Metab Syndr. 2018:125-137. doi:10.1016/b978-0-12-812019-4.00010-6

Zha D, Yao T, Bao L, Gao P, Wu X. Telmisartan attenuates diabetic nephropathy progression by inhibiting the dimerization of angiotensin type-1 receptor and adiponectin receptor-1. Life Sci. 2019;221(August 2018):109-120. doi:10.1016/j.lfs.2019.01.044

Van Buren PN, Toto R. Hypertension in Diabetic Nephropathy: Epidemiology, Mechanisms, and Management. Adv Chronic Kidney Dis. 2011;18(1):28-41. doi:10.1053/j.ackd.2010.10.003

Pitrosch F, Herbrig K, Kinder B, Passauer J, Fisher S GP. Rosiglitazone improves glomerular hyperfilteration, renal endothelial dysfunction and microalbuminuria of incipient diabetic nephropathy in patients. Diabetes. 2005;54:2206–11.

Nagai T, Tomizawa T MM. Effect of bezafibrate or pravastatin on serum lipid level and albuminuria in NIDDM patients. J Atheroscler Thromb. 2000;7:91–6.

Bonnet F CM. Potential influence of lipids in diabetic nephropathy: insights from experimental data and clinical studies. Diab Metab. 2000;26:254–64.

Ravid M, Neumann L LM. Plasma lipids and progression of nephropathy in diabetes mellitus type II: effect of ACE inhibitors. Kidney Int. 1995;47:907–10.

Rosario RF SP. Lipids and diabetic nephropathy. Curr Diab Rep. 2006;6:455–62.

Munter P, Coresh J, Smith JC, Eckfeldt J KM. Plasma lipids and risk of developing renal dysfunction: the atherosclerosis risk in communities study. Kidney Int. 2000;58:293–301.

Wang Z, Jiang T, Li J, Proctor G, McManaman JL, Lucia S et al. Regulation of renal lipid metabolism, lipid accumulation and glomerulosclerosis in FVBdb/db mice with type 2 diabetes. Diabetes. 2005;54:2328–35.

Sun L, Halaihel N, Zhang W, Rogers T LM. Role of sterol regulatory element-binding protein-1 in regulation of renal lipid metabolism and glomerulosclerosis in diabetes mellitus. J Biol Chem. 2002;277:18919–27.

Balakumar P, Arora MK, Singh M. Emerging role of PPAR ligands in the management of diabetic nephropathy. Pharmacol Res. 2009;60(3):170-173. doi:10.1016/j.phrs.2009.01.010

Rippin J, Bain SC, Barnett AH. Rationale and design of diabetics exposed to telmisartan and enalapril (DETAIL) study. J Diabetes Complications. 2002;16(3):195-200. doi:10.1016/S1056-8727(01)00165-9

Bakris G, Burgess E, Weir M, Davidai G, Koval S. Telmisartan is more effective than losartan in reducing proteinuria in patients with diabetic nephropathy. Kidney Int. 2008;74(3):364-369. doi:10.1038/ki.2008.204

Aranda P, Segura J, Ruilope LM, et al. Long-term renoprotective effects of standard versus high doses of telmisartan in hypertensive nondiabetic nephropathies. Am J Kidney Dis. 2005;46(6):1074-1079. doi:10.1053/j.ajkd.2005.08.034

Schmieder RE, Delles C, Mimran A, Fauvel JP RL. Impact of telmisartan versus ramipril on renal endothelial function in patients with hypertension and type 2 diabetes. Diabetes Care. 2007;30:1351-1356.


Refbacks

  • There are currently no refbacks.