Effect of Pioglitazone on Proteinuria in Non-Diabetic Renal Patients: A Self-Control Clinical Trial

Document Type : Original Article(s)

Authors

1 Associate Professor, Isfahan Kidney Diseases Research Center, Department of Nephrology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran.

2 Resident, Department of Internal Medicine, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran.

3 Assistant Professor, Isfahan Kidney Diseases Research Center, Department of Nephrology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran.

4 Associate Professor, Department of Nephrology, School of Medicine and Isfahan Kidney Diseases Research Center, Isfahan University of Medi-cal Sciences, Isfahan, Iran.

5 Epidemiologist, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran.

6 Assistant Professor, Department of Nephrology, School of Medicine and Isfahan Kidney Diseases Research Center, Isfahan University of Medical Sciences, Isfahan, Iran.

Abstract

Background: Proteinuria has independent deleterious effects on the progression of chronic renal disease. The aim of this study was to determine effect of pioglitazone on proteinuria in patients with non-diabetic renal disease. Methods: This was a self-controlled clinical trial study conducted in Al-Zahara Hospital and few private clinics of nephrology in Isfahan. Forty four non-diabetic patients aged 18 and over, who had renal disease and stable proteinuria over 0.5 g in 24 h and body mass index (BMI) lower than 30 kg/m2, were enrolled in the study. Patients were treated by 15 mg of pioglitazone for 4 months. The primary end point was urine protein excretion, measured prior to the study, at the end of 2 and 4 months during treatment as well as 2 months after cessation of pioglitazone. Secondary end points included systolic blood pressure, creatinine, ALT, AST, FBS, BUN and GFR levels. Findings: Mean urine protein excretion was 1088.6 ± 775.6 mg/24 h before treatment; therefore mean urine protein excretion at the end of 4th month was 433.9 ± 406.2 mg/24 h) P<0.001, CI95%: 0.49-0.82). There was no significant trend for systolic blood pressure, creatinine, ALT, AST, FBS, BUN and GFR levels to increase or decrease during the follow-up period (P> 0.01). Conclusion: Considering complications of proteinuria followed by gradual kidney malfunction based on findings of present study, pioglitazone could significantly decrease proteinuria in patients with non-diabetic kidney diseases. Key words: Proteinuria, Pioglitazone, Non-diabetic renal disease, Hypoglycemic agent.