Korean J Intern Med.  2009 Sep;24(3):227-232. 10.3904/kjim.2009.24.3.227.

Long-Term Effects of Rosiglitazone on the Progressive Decline in Renal Function in Patients With Type 2 Diabetes

• Kim MK
• Ko SH
• Baek KH
• Ahn YB
• Yoon KH
• Kang MI
• Lee KW
• Song KH

• KMID: 1717946
• DOI: http://doi.org/10.3904/kjim.2009.24.3.227

Abstract

BACKGROUND/AIMS
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 theatment slows the progressive deterioration of renal function in patients with type 2 diabetes.

Keyword

Diabetic nephropathies; Rosiglitazone; Renal insufficiency

MeSH Terms

Adult
Aged
Diabetes Mellitus, Type 2/*drug therapy/physiopathology
Diabetic Nephropathies/*prevention & control
Female
Glomerular Filtration Rate
Humans
Hypoglycemic Agents/*therapeutic use
Kidney/*physiopathology
Male
Middle Aged
Retrospective Studies
Thiazolidinediones/*therapeutic use