title: Long-term effects of rosiglitazone on the progressive decline in renal function in patients with type 2 diabetes.
abstract: OBJECTIVE
  Thiazolidinediones reduce urinary albumin excretion and may prevent the development of renal injury. We evaluated the long-term effects of rosiglitazone on the progression of renal dysfunction in patients with type 2 diabetes mellitus.
  
  
  METHODS
  We enrolled patients with type 2 diabetes mellitus who initially had normal or mildly impaired renal function, defined as an estimated glomerular filtration rate (eGFR) of 60-120 mL/min per 1.73 m2, and normoalbuminuria. Patients were divided into two groups according to their use of rosiglitazone during 3 years of follow-up: those treated with rosiglitazone (rosiglitazone group, n=52) and those treated without rosiglitazone (control group, n=85). Progression of renal dysfunction was defined as a decrease in eGFR of >or=9 mL/min per 1.73 m2 after 3 years.
  
  
  RESULTS
  A greater difference was observed in the decrease in eGFR between the rosiglitazone and control groups after 3 years (3.8+/-9.9 vs. 12.6+/-10.5 mL/min per 1.73 m2, p<0.001). Seventeen of 52 (32.7%) patients in the rosiglitazone group and 53 of 85 (62.3%) patients in the control group showed progression of renal dysfunction (p=0.001). The progressors had a longer duration of diabetes (6.7+/-5.9 vs. 3.9+/-4.1 years, p=0.002), higher HbA1c levels (7.4+/-1.8 vs. 6.8+/-1.3%, p=0.023), and less frequent use of rosiglitazone (24.2 vs. 52.2%, p<0.001) compared to non-progressors. Multiple logistic regression analysis revealed that the use of rosiglitazone was a significant and independent predictor of the progression of renal dysfunction.
  
  
  CONCLUSIONS
  This study suggests that rosiglitazone treatment slows the progressive deterioration of renal function in patients with type 2 diabetes.
authors.affiliation: Department of Internal Medicine, The Catholic University of Korea College of Medicine, Seoul, Korea.
authors.forename: Mee Kyoung
authors.initials: MK
authors.lastname: Kim
authors.forename: Seung-Hyun
authors.initials: SH
authors.lastname: Ko
authors.forename: Ki-Hyun
authors.initials: KH
authors.lastname: Baek
authors.forename: Yu-Bae
authors.initials: YB
authors.lastname: Ahn
authors.forename: Kun-Ho
authors.initials: KH
authors.lastname: Yoon
authors.forename: Moo-Il
authors.initials: MI
authors.lastname: Kang
authors.forename: Kwang-Woo
authors.initials: KW
authors.lastname: Lee
authors.forename: Ki-Ho
authors.initials: KH
authors.lastname: Song
mesh_terms: D000328:Adult; D000368:Aged; D003924:Diabetes Mellitus, Type 2 / Q000188:drug therapy* / Q000503:physiopathology; D003928:Diabetic Nephropathies / Q000517:prevention & control*; D005260:Female; D005919:Glomerular Filtration Rate; D006801:Humans; D007004:Hypoglycemic Agents / Q000627:therapeutic use*; D007668:Kidney / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D000077154:Rosiglitazone; D045162:Thiazolidinediones / Q000627:therapeutic use*
chemical_list: D007004:Hypoglycemic Agents; D045162:Thiazolidinediones; D000077154:Rosiglitazone