Evaluation of role of Low Molecular Weight Heparin and Vitamin E on renal functions in patients with diabetic nephropathy

Abstract

Objectives: Diabetes has been reported to increase the risk of end stage renal disease. To prevent the progres­sion of diabetic nephropathy (DN) search for newer ap­proaches is warranted as diabetic patients despite good metabolic control show progressive renal damage. The aim of this study was to investigate the role of low molecu­lar heparin (LWMH) and vitamin E in patients with diabetic nephropathy. Materials and methods: Twenty five clinically proved adult cases of DN with adequate glycemic and blood pressure control achieved with insulin or oral hypoglyce­mics and anti hypertensive agents (excluding ACE inhibi­tors and ARBs) were included. At the start of the study, patients were put on LWMH (3200 IU S/C once daily) for one month and thereafter a washout period of one month was given, following which patients received anti-oxidant vitamin-E (200mg, once daily) for three months. Results: Patients at the baseline have microalbuminuria levels ranging for 41.0 to 290.0 mg/ 24hr. One month of LMWH reduced it from 133.0±74.4 to 93.3±62.1 mg/24hr (p0.05). The microalbuminuria levels did not revert back to the baseline till the end of the study (5 months). Conclusion: Our results indicated that, though not a part of standard regime, LMWH treatment followed by vitamin E supplementation needs to be considered in the incipient stage of DN.

Keywords

• Low molecular weight heparin, vitamin E, diabetic nephropathy, renal functions

Evaluation of role of Low Molecular Weight Heparin and Vitamin E on renal functions in patients with diabetic nephropathy

Abstract

Amaç: Diyabetin son dönem böbrek yetmezliği riskini artırdığı bildirilmiştir. Diyabetik nefropatinin ilerlemesini önlemede yeni yaklaşımlar gereklidir, çünkü iyi metabolik kontrole rağmen diyabetik hastalar ilerleyici böbrek hasa­rı gösterir. Bu çalışmanın amacı düşük molekül ağırlıklı heparin ve vitamin E\'nin diyabetik nefropatili hastalardaki rolünü araştırmaktır. Gereç ve yöntem: Klinik olarak kanıtlanmış, yeterli gli­semik kontolu ve kan basıncı kontrolu insulin, oral hipog­lisemikler ve kan basıncı düşürücüler (ACE inhibitörü ve ARB\'ler hariç) ile sağlanmış, diyabetik nefropatisi olan 25 erişkin hasta çalışmaya dahil edildi. Çalışmanın başlangı­cında hastalara DMAH (3200 Ünite, subkutan günde bir kez) bir ay verildi ve takiben bir ay beklenip daha sonra üç ay süreyle E vitamini (Günde bir kez 200 mg) verildi. Bulgular: Hastaların bazal mikroalbuminüri değerleri, 41.0 ile 290.0 mg/24 st arasında değişiyordu. Bir aylık DMAH bu değeri 133.0 ± 74.4 mg/24 st\'den 93.3 ± 62.1 mg/24 st\'e düşürdü (p 0.05). Mikro­albuminüri değerleri çalışma süresi olan 5 ayın sonunda başlangıçtaki bazal değerlere dönmemiş olduğu görüldü. Sonuç: Çalışmamızın sonuçlarına göre, standart tedavi rejiminin bir parçası olmasa bile, DMAH ve takiben vita­min E tedavisinin diabetik nefropati beklenen dönemde dikkate alınması gerekir.

Keywords

• Düşük molekül ağırlıklı heparin, vita­min E, diyabetik nefropati, böbrek fonksiyonları

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