Effect of ramipril on glycosylated hemoglobin and liver function test in patients of diabetic nephropathy.

ABSTRACT

Background: Diabetic nephropathy (DN) is a chronic complication of diabetes mellitus with a growing incidence. Therefore, it is essential to have a better understanding of it, especially in relation to prevention and aggressive management to avoid progression to end-stage renal disease. Methods: This prospective randomized study represented the effects of ramipril on glycosylated hemoglobin (HbA1c), liver function tests (LFT), mean arterial blood pressure, and serum potassium level in patients diagnosed with DN, with concomitant mild to moderate hypertension. 135 diagnosed patients with DN treated with ramipril 5 mg daily for 3 months were involved in this study. Blood samples were taken from all patients and analyzed for HbA1c, LFT including alanine aminotransferase (ALT), aspartate aminotransferase (AST), serum alkaline phosphatase (ALP), and bilirubin with serum potassium level. After 3 months of treatment with ramipril (5 mg daily), blood samples were collected and analyzed again to determine the same parameters. Results: Ramipril produced a signifi cant reduction in (HbA1c) of hypertensive patients (p<0.05), whereas, serum levels of ALT, AST, ALP, and bilirubin were signifi cantly elevated. The results indicated that ramipril may cause liver injury. Meanwhile, the mean arterial pressure was decreased signifi cantly by ramipril (p<0.05). Conclusion: The present study concluded that ramipril signifi cantly reduced the percentage of HbA1c but may cause liver injury, monitoring of liver enzymes is advisable for patients on ramipril.