Enhanced Peritubular Capillary Flow and Renal Function Can Be Accomplished in Normoalbuminuric Type 2 Diabetic Nephropathy

• Published in: Renal failure Vol. 33; no. 3; pp. 312 - 315
• Main Authors: Futrakul, N., Kulaputana, O., Futrakul, P., Chavanakul, A., Deekajorndech, T.
• Format: Journal Article
• Language: English
• Published: England Informa Healthcare 01.04.2011; Taylor & Francis
• Subjects: Adult; Aged; Diabetic Nephropathies - drug therapy; Diabetic nephropathy; Female; hemodynamics; Humans; Kidney - drug effects; Kidney Function Tests; Male; Microcirculation - drug effects; Middle Aged; Prospective Studies; Renal Circulation - drug effects; vascular homeostasis; vasodilator; Vasodilator Agents - pharmacology; Vasodilator Agents - therapeutic use; Young Adult
• ISSN: 0886-022X; 1525-6049
• DOI: 10.3109/0886022X.2011.560405

Under common practice, treatment of diabetic nephropathy (DN) is usually initiated at late stage of CKD due to the insensitiveness of the available diagnostic markers. Such treatment fails to restore renal perfusion and function. This is due to the defective mechanism of vascular homeostasis and impaired nitric oxide production observed in late stage of DN. In contrast, the mechanism of vascular repair is adequately functional in early stage of DN (normoalbuminuria). In this study, we treated 50 normoalbuminuric diabetic patients with multidrug vasodilators, namely ACE inhibitor, angiotensin receptor blocker, ± calcium channel blocker in conjunction with correction of metabolic disorders for 24-36 months. Following the treatment, increment in peritubular capillary flow in response to vasodilators was observed, and thus supports the adequate role of vascular repair. In addition, increase in renal function documented in this study also implies that an effective preventive strategy to minimize end-stage renal disease can be accomplished in normoalbuminuric DN.