Currently available glitazones do vary in their impact on lipid profiles, indicating sub-class variations in effect. Nonetheless, both agents appear to have effects on the development and progression of kidney disease in individuals with type 2 diabetes. The effects of probucol treatment on the progression of diabetic nephropathy was evaluated in a randomized open study of 102 people with type 2 diabetes with clinical albuminuria (UAE > 300 mg/g Cr).117 The mean follow up period was 28.5 months for all patients and 18.6 months for advanced patients (defined as those having serum Cr > 2.0 mg/dL). The mean interval to initiation of haemodialysis was significantly longer in probucol patients. In
advanced cases treated with probucol, Dorsomorphin molecular weight increases in serum creatinine and urinary protein were significantly suppressed and the haemodialysis-free rate was significantly higher. The study concluded that probucol may suppress the progression of diabetic nephropathy as a consequence of the anti-oxidative effect of the drug. The multifactorial intensive treatment of the STENO2 reduced the risk of nephropathy by 50%.63 This long-term study (mean 7.8 years) of 160 people with type 2 diabetes and microalbuminuria, utilized multifactorial interventions for modifiable risk factors for cardiovascular disease which included blood lipid Epigenetics inhibitor control with statins and fibrates. While
the intensive treatment group achieved a significantly lower blood glucose concentration, given the multifactorial nature of the study it is not possible to determine the relative contribution of the intensive lipid treatment may have had. There are insufficient studies of suitable quality to enable dietary recommendations to be made with respect to CKD in people with type 2 diabetes (Evidence Level II – Intervention). Lifestyle modification (diet and physical activity) is an integral component of diabetes care (refer to the guidelines for Blood Glucose Control in type 2 diabetes). However, there are few studies that have specifically Selleck Paclitaxel addressed kidney related outcomes in type 2 diabetes and as such
it is not possible to currently make recommendations specific to the management of CKD. The following sections summarize the current evidence in relation to alternate diets, protein restriction, and salt. The Diabetes and Nutrition Clinical Trial (DCNT) is a population based prospective, observational multicentre study designed to evaluate the nutritional pattern of people with diabetes in Spain and associations with diabetic complications.118 The study (total 192) included a mix of people with type 2 diabetes (99) and type 1 diabetes (93). Nephropathy progression was indicated by change from normoalbuminuria to microalbuminuria and microalbuminuria to macroalbuminuria. Regression was indicated by change from microalbuminuria to normoalbuminuria.