Comparative study on renoprotective effect of aliskiren-pentoxifylline combination, valsartan and enalapril among patients with hypertension, type 2 diabetes mellitus and diabetic nephropathy

ABSTRACT

This study was conducted to evaluate the renoprotective effect of aliskiren-pentoxifylline combination and compare it with enalapril and valsartan in patients with hypertension, type 2 diabetes mellitus and diabetic nephropathy [DN]. Sixty patients with hypertension, type 2 diabetes mellitus and microalbuminurea [20-200microg/min or 30-300mg/24h] were selected from UNRWA and private clinics in Ga/a Strip and divided into three groups. The first group [n=20] was treated with enalapril [10-20mg/day], the second group [n=20] was treated with valsartan [I60mg/day], whereas the third group [n=20] was treated with aliskiren-pentoxifylline combination [150,400mg/day]. All patients were follovved-up for nine months by measuring serum creatinine level and urinary albumin excretion [UAE] rate before and at 3, 6 and 9 months of treatment. Paired T-test and independent T-test were used to analyze our results and the significance was tested at p< 0.05. The results showed a significant reduction in both UAE rate and serum creatinine level among patients who used aliskiren-pentoxifylline combination after 6 and 9 months of treatment, where the reduction was highly significant after 9 months of treatment [p=0.001 for UAE, p=0.000 for serum creatinine level]. In the valsartan treated group, the reduction in UAE rate was significant [p=0.045] after 9 months of treatment, while no significant reduction was noticed in serum creatinine level [p=0.807]. Moreover, no significant reduction was seen in UAE rate [p=0.125] and serum creatinine level [p=0.445] among patients who were given enalapril. In conclusion, aliskiren-pentoxifylline combination showed renoprotective effect more distinct than enalapril and valsartan among patients with DN