title: Renoprotection provided by losartan in combination with pioglitazone is superior to renoprotection provided by losartan alone in patients with type 2 diabetic nephropathy.
abstract: OBJECTIVE
  This study was performed to ascertain whether losartan combined with pioglitazone is superior to losartan alone in delaying the progression of chronic renal failure in patients with type 2 diabetic nephropathy.
  
  
  METHODS
  Sixty patients with type 2 diabetic nephropathy (stage 3 or 4 chronic kidney disease) were enrolled in a randomized, controlled trial. Thirty patients received losartan (100 mg/day) and pioglitazone (30 mg/day), and 30 patients received losartan only (100 mg/day). The patients were assessed at baseline and at 3-month intervals for 24-hour urinary protein excretion, serum creatinine, creatinine clearance, and fasting blood glucose values. The glomerular filtration rate was measured by means of a (99m)Tc-diethylenetriamine penta-acetic renogram at baseline and after 12 months.
  
  
  RESULTS
  As compared with therapy with losartan alone, the losartan-pioglitazone combination therapy resulted in significantly lower serum creatinine and fasting glucose values at 12 months and in significantly lower degrees of proteinuria at 6 and 12 months. The declines in creatinine clearance and glomerular filtration rate below baseline measurements at stages 3 and 4 of chronic kidney disease were significantly slower for the losartan-pioglitazone group as compared with the losartan-only group.
  
  
  CONCLUSIONS
  Renoprotection conferred by losartan combined with pioglitazone is superior to that conferred by losartan alone in subjects with type 2 diabetic nephropathy. The combination is generally well tolerated.
authors.affiliation: Division of Nephrology, No. 3 People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, PR China. hmjgli@yahoo.com.cn <hmjgli@yahoo.com.cn>
authors.forename: Hui Min
authors.initials: HM
authors.lastname: Jin
authors.forename: Yu
authors.initials: Y
authors.lastname: Pan
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003924:Diabetes Mellitus, Type 2 / Q000188:drug therapy / Q000503:physiopathology / Q000517:prevention & control*; D003928:Diabetic Nephropathies / Q000188:drug therapy / Q000503:physiopathology / Q000517:prevention & control*; D004359:Drug Therapy, Combination; D005260:Female; D006801:Humans; D007676:Kidney Failure, Chronic / Q000188:drug therapy / Q000503:physiopathology / Q000517:prevention & control*; D019808:Losartan / Q000008:administration & dosage*; D008297:Male; D008875:Middle Aged; D000077205:Pioglitazone; D045162:Thiazolidinediones / Q000008:administration & dosage*
chemical_list: D045162:Thiazolidinediones; D019808:Losartan; D000077205:Pioglitazone