Abstract

ASSESSING THE IMPACT OF ANTIHYPERTENSIVES IN KIDNEY FUNCTION OF PATIENTS WITH DIABETIC NEPHROPATHY

Aiswarya G.*, Reshma T., Silpa K.K., Rajeev P. Thomas and Reeta James

Abstract

Objective: The objective of the study was to determine the impact of anti-hypertensives (ARB, ACEI, CCB, Beta Blockers and Diuretics) in kidney function (Proteinuria, Serum Creatinine, eGFR) of patients with Diabetic Nephropathy. Methods: A prospective observational study conducted on patients with diabetic nephropathy (DN) in tertiary care teaching hospital, kerala, south India. 107 DN patients were enrolled in the study. The baseline serum creatinine and proteinuria were assessed from laboratory data and patient’s medical records. eGFR were calculated by MDRD formula. A follow up was conducted on the third month recording the levels of serum creatinine, proteinuria and eGFR. Results: Out of 107 patients were enrolled into the study, 46.43% prescribed with ARBs, 7.35% with ACEIs, 19.11% with CCBs, 15.44% with Beta blockers and 11.76% with Diuretics. Most prescribed drug was Telmisartan (39.41%) and ACE Inhibitors were the least prescribed due to its side effects. While comparing the baseline and follow up values of kidney function variables among the selected antihypertensive classes, a decline in proteinuria, the main indicator of DN was only seen with RAAS Inhibitors. But an improvement in other variables like serum creatinine and eGFR were noted with other class of antihypertensives. Conclusion: ARB showed the most beneficial impact in reducing proteinuria in type II DN patients and the study concluded that antihypertensives had a significant role in preventing the progression of Diabetic Nephropathy in which ARB are the best drug of choice.

Keywords: Diabetic nephropathy, Antihypertensives, Proteinuria.