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

Year 2011, Volume: 38 Issue: 2, 129 - 133, 01.06.2011

Hari Krishan Aggarwal Deepak Jain Sonia Sindhu Raj Yadav

https://doi.org/10.5798/diclemedj.0921.2011.02.0001

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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