Comparison of the effect of pentoxifylline and captopril on proteinuria in patients with type 2 diabetes mellitus.
OBJECTIVE
To compare the relative efficacy of pentoxifylline (PTX) and angiotensin-converting enzyme (ACE) inhibitor, captopril in the treatment of proteinuria of type 2 diabetic patients.


METHODS
A randomized open, crossover, clinical trial conducted from October 2000 to March 2001.


METHODS
39 patients with type 2 diabetes age 34-75 years were randomly allocated to the two treatment groups. The first group received PTX (400 mg three times a day) orally for a total of 2 months. The second group received captopril (25 mg three times a day) for 2 months. Response to treatment was assessed at 1, 2, 4, and 8 weeks after start of therapy.


RESULTS
Captopril appeared to be equivalent in efficacy and safety to PTX. A significant decrease in proteinuria occurred in both groups. Of the 20 patients treated with PTX, the mean (SD) of 24 h urinary protein decreased from 1.4 (0.7) to 1.0 (0.7) g/24 h (p < 0.05). Correspondingly, in the 19 patients treated with captopril, the mean (SD) of 24 h urinary protein decreased from 1.3 (0.7) to 0.8 (0.7) g/24 h (p < 0.01).


CONCLUSIONS
This study demonstrates that treatment with PTX and captopril both significantly reduce overt proteinuria in patients with type 2 diabetes. This effect of ACE inhibition has previously been shown to slow progression to renal failure and we postulate that treatment with PTX may have a similar benefit.
Aminorroaya
Ashraf
A
Isfahan Endocrinology and Metabolism Research Center, Isfahan University of Medical Sciences and Health Services, Isfahan, Iran.
Janghorbani
Mohsen
M
Rezvanian
Hassan
H
Aminian
Taghi
T
Gharavi
Manouchehr
M
Amini
Massoud
M
D000328:Adult; D000368:Aged; D002216:Captopril / Q000627:therapeutic use*; D018592:Cross-Over Studies; D003924:Diabetes Mellitus, Type 2 / Q000150:complications*; D003928:Diabetic Nephropathies / Q000188:drug therapy*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010431:Pentoxifylline / Q000627:therapeutic use*; D011507:Proteinuria / Q000188:drug therapy*
D002216:Captopril; D010431:Pentoxifylline