Reduction of proteinuria by rosiglitazone in non-diabetic renal disease.
OBJECTIVE
To investigate the effect of a thiazolidinedione on proteinuria in patients with non-diabetic renal disease.


METHODS
In an open-label randomized cross-over study, 40 adults with chronic non-diabetic renal disease completed the study. In a random fashion, one group was treated for 4 months with 4 mg of rosiglitazone first followed by a 4-month period of standard treatment. The opposite order was used for the second group.


RESULTS
Baseline urinary protein excretion rate was 1.45 g/24 h. On rosiglitazone, there was a drop of urinary protein level of 0.24 g/24 h (P=0.045). In contrast, there was a trend for proteinuria to increase during the control period (0.12 g/24 h, P=0.18). The urine protein level on rosiglitazone was lower than on usual treatment (0.36 g/24 h, P=0.002, 95% CI 0.15-0.58). There was a similar beneficial effect on systolic blood pressure which was reduced by rosiglitazone by 7.8 mmHg (P=0.006, 95% CI 2.6-13.1). Although average fasting glucose was only 5.8 mmol/L, there was a significant Spearman correlation between fasting glucose and a reduction in urinary protein levels (r=0.34, P=0.045).


CONCLUSIONS
It is concluded that thiazolidinediones may have a role in the management of non-diabetic proteinuria of various aetiologies. In this study the average body mass index was 28.9 kg/m2. It will be important to repeat these studies in non-overweight subjects with non-diabetic proteinuria and in addition to trial maximal therapeutic doses of the thiazolidenedione.
Kincaid-Smith
Priscilla
P
Epworth Hospital, Department of Pathology, Faculty Education Unit, University of Melbourne, Melbourne, Victoria, Australia.
Fairley
Kenneth F
KF
Farish
Stephen
S
Best
James D
JD
Proietto
Joseph
J
D000328:Adult; D000368:Aged; D015415:Biomarkers / Q000652:urine; D001786:Blood Glucose / Q000378:metabolism; D015992:Body Mass Index; D018592:Cross-Over Studies; D003920:Diabetes Mellitus; D018450:Disease Progression; D004305:Dose-Response Relationship, Drug; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007004:Hypoglycemic Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D007328:Insulin / Q000097:blood; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000150:complications* / Q000378:metabolism; D047495:PPAR gamma; D011507:Proteinuria / Q000188:drug therapy* / Q000209:etiology / Q000378:metabolism; D012189:Retrospective Studies; D000077154:Rosiglitazone; D045162:Thiazolidinediones / Q000008:administration & dosage / Q000627:therapeutic use*; D016896:Treatment Outcome
D015415:Biomarkers; D001786:Blood Glucose; D007004:Hypoglycemic Agents; D007328:Insulin; D047495:PPAR gamma; D045162:Thiazolidinediones; D000077154:Rosiglitazone