title: Clinical study of double dose of valsartan combined with tacrolimus in treatment of diabetic nephropathy.
abstract: OBJECTIVE
  To investigate the clinical effect of double dose of valsartan combined with tacrolimus in the treatment of diabetic nephropathy (DN).
  
  
  METHODS
  HA total of 86 cases diagnosed with DN were selected from October 2013 to October 2014 in Zaozhuang Municipal Hospital, China. The study was approved by our hospital Ethics Committee and written consent was obtained from patients and their family members. Patients were randomly divided into three groups according to the sequence of admission, group A (conventional dose of valsartan group, n = 28 cases), group B (double dose of valsartan group, n = 29 cases) and group C (double dose of valsartan combined with tacrolimus group, n = 29). Clinical effects were compared by analyzing the renal function tests after 8 weeks.
  
  
  RESULTS
  24h urine protein, serum creatinine level of patients in group B and group C were significantly lower than that of group A. Those in group C was much lower. The glomerular filtration rates were significantly higher for group B and C than that of group A, and those in group C were much higher. The difference is statistically significant (p < 0.05). High-sensitivity C-reactive protein (hs CRP) and adiponectin levels of patients in group B and C of were significantly lower than that of group A and those in group C were much lower. The difference is statistically significant (p < 0.05). The high mobility group protein 1 (HMGB1) and renal tubular and interstitial damage index (TDI) of patients in B and C groups were significantly lower than those in the A group, and those in C group were significantly lower. The difference was statistically significant p < 0.05). The clinical effective rates of patients in group B and C were significantly higher than that in group A, and those of group C were much higher. The difference is statistically significant (p < 0.05). The recurrence rates of patients in group B and group C were significantly lower than those of group A and those in group C were much lower. The difference is statistically significant (p < 0.05). Patients in three groups showed no obvious drug complications.
  
  
  CONCLUSIONS
  Double dose of valsartan combined with tacrolimus treatment of DN patients can improve clinical symptoms, reducing inflammation, inhibiting or even reversing the interstitial fibrosis, which will improve the curative effect and reduce the recurrence, as to provide a new theoretical basis for the clinical treatment of the disease.
authors.affiliation: Department of Nephrology, Zaozhuang Municipal Hospital, Zaozhuang, Shandong, China. ejka827@163.com.
authors.forename: H
authors.initials: H
authors.lastname: Jin
authors.forename: H-N
authors.initials: HN
authors.lastname: Zhang
authors.forename: X-L
authors.initials: XL
authors.lastname: Hou
authors.forename: B
authors.initials: B
authors.lastname: Zhang
authors.forename: J
authors.initials: J
authors.lastname: Wu
authors.forename: H-B
authors.initials: HB
authors.lastname: Zhang
mesh_terms: D000328:Adult; D000368:Aged; D003928:Diabetic Nephropathies / Q000188:drug therapy* / Q000503:physiopathology; D004305:Dose-Response Relationship, Drug; D004359:Drug Therapy, Combination; D005260:Female; D005919:Glomerular Filtration Rate / Q000187:drug effects; D006801:Humans; D008297:Male; D008875:Middle Aged; D012076:Renal Agents / Q000008:administration & dosage*; D016559:Tacrolimus / Q000008:administration & dosage*; D000068756:Valsartan / Q000008:administration & dosage*
chemical_list: D012076:Renal Agents; D000068756:Valsartan; D016559:Tacrolimus