Abstract

DIABETIC NEPHROPATHY: MEANS OF PHARMACOLOGICAL INTERVENTION

*Dr. Suma Jayaram and Dr. Basavaraj Bhandare

Abstract

Background: Diabetic nephropathy is the leading cause of chronic kidney disease and end-stage renal disease in developing countries. It is characterized by persistent albuminuria and a progressive decline in renal function. Objective: The objective of this study was to analyze the prescribing pattern and rationality of drug treatment in diabetic nephropathy patients in accordance to Kidney Disease Outcomes quality Initiative (KDOQI) guidelines. Material & methods: After obtaining IEC approval, a prospective, observational non interventional study was conducted in The Department of Nephrology in a tertiary care hospital for six months. A total of 116 consenting diabetic nephropathy patients’ demographics and pharmacological interventions were analyzed. Data obtained was evaluated using descriptive statistics. Results: The patients were in the age group of 50 - 70 years with a documented diagnosis of diabetes mellitus, hypertension and proteinuria. There was a male preponderance of 77%. Anti hypertensive poly-therapy was observed. As monotherapy, Enalapril (75%) was the most common drug prescribed, followed by Telmisartan (25%). As combination therapy, enalapril with chlorthalidone was the most common. Mixtard 50(50% soluble and 50% isophane) was the most commonly prescribed antidiabetic medication (86%). Statins were administered to all the patients, atorvastatin (78%) being the most common. Conclusion: In this study antihypertensive poly-therapy was observed in the majority, with ACE inhibitors being the most frequently prescribed. Insulin mixtard was preferred to hypoglycemic drugs. It was found that the prescription pattern analyzed in this study was adherent to the KDOQI guidelines.

Keywords: Albuminuria, ACE Inhibitors, Diabetic nephropathy, Insulin.