title: Long-term effect of epalrestat, an aldose reductase inhibitor, on the development of incipient diabetic nephropathy in Type 2 diabetic patients.
abstract: The aim of the present study was to elucidate the long-term effect of epalrestat, an aldose reductase inhibitor (ARI), on renal function in patients with type 2 diabetes mellitus showing microalbuminuria. Patients were allocated to two groups (cases and controls) matched for age, BMI, and the extent of urinary albumin excretion (UAE). Thirty-five type 2 diabetic patients presenting microalbuminuria were included in this study: cases were treated with epalrestat (150 mg/day) for 5 years. No significant changes were found in blood pressure, HbA1c, and total cholesterol in either group during the observation period. In the control group, UAE increased significantly (P<.01) from 82+/-12 mg/g Cr at the baseline to 301+/-111 mg/g Cr at the end of the study, while UAE remained unchanged, 81+/-15 mg/g Cr at the baseline and 87+/-19 mg/g Cr at the end of the study, in the epalrestat-treated group. Reciprocal creatinine measured by an enzyme assay decreased significantly (P<.01) in both groups; however, the reduction rate in the epalrestat-treated group was significantly (P<.05) smaller than that in the control group. These results suggest the potential usefulness of ARIs in preventing the progression of incipient diabetic nephropathy in patients with type 2 diabetes mellitus.
authors.affiliation: Second Department of Internal Medicine, Toho University, School of Medicine, 6-11-1 Omori-Nishi, Ota-ku, Tokyo 143-8541, Japan.
authors.forename: K
authors.initials: K
authors.lastname: Iso
authors.forename: H
authors.initials: H
authors.lastname: Tada
authors.forename: K
authors.initials: K
authors.lastname: Kuboki
authors.forename: T
authors.initials: T
authors.lastname: Inokuchi
mesh_terms: D000419:Albuminuria / Q000209:etiology; D000449:Aldehyde Reductase / Q000037:antagonists & inhibitors*; D016022:Case-Control Studies; D003404:Creatinine / Q000097:blood; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000188:drug therapy* / Q000652:urine; D003928:Diabetic Nephropathies / Q000517:prevention & control*; D004791:Enzyme Inhibitors / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012016:Reference Values; D012236:Rhodanine / Q000031:analogs & derivatives* / Q000627:therapeutic use*; D053778:Thiazolidines; D013997:Time Factors
chemical_list: D004791:Enzyme Inhibitors; D053778:Thiazolidines; C038131:epalrestat; D012236:Rhodanine; D003404:Creatinine; D000449:Aldehyde Reductase