Effect of the antiplatelet drug dilazep dihydrochloride on urinary podocytes in patients in the early stage of diabetic nephropathy.

Abstract

OBJECTIVE:

To determine whether the antiplatelet drug dilazep dihydrochloride affects the number of urinary podocytes in diabetic patients with microalbuminuria.

RESEARCH DESIGN AND METHODS:

Fifty patients with type 2 diabetes and microalbuminuria (30 men and 20 women, mean age 48.6 years) and 30 age-matched control subjects (18 men and 12 women, mean age 49.2 years) were included in the study. No patients showed serum creatinine levels in excess of 2.0 mg/dl. Urinary podocytes were examined by immunofluorescence microscopy with monoclonal antibodies against podocalyxin.

RESULTS:

Urinary podocytes were detected in 18 of the 50 microalbuminuric diabetic patients (mean, 1.3 cells/ml). Urinary podocytes were not detected in the remaining 32 patients or in the 30 healthy control subjects. Diabetic patients positive for urinary podocytes were divided into 2 treatment groups: a dilazep dihydrochloride treatment group (300 mg/day; n = 9, group A) and a placebo group (n = 9, group B). Treatments were continued for 6 months. In group A, microalbuminuria decreased significantly from 146 +/- 42 to 86 +/- 28 microg/min (P < 0.01) and urinary podocytes also decreased from 1.3 +/- 0.8 to 0.4 +/- 0.2 cells/ml (P < 0.01). However, in group B, microalbuminuria and urinary podocytes changed little over the study period.

CONCLUSIONS:

Podocyte injury may occur in patients with early diabetic nephropathy, and dilazep dihydrochloride may be useful for preventing glomerular injury.

• Authors: T Nakamura, C Ushiyama, N Shimada, K Sekizuka, I Ebihara, M Hara, H Koide
• Journal: Diabetes care (Diabetes Care) Vol. 23 Issue 8 Pg. 1168-71 (Aug 2000) ISSN: 0149-5992 [Print] United States
• PMID: 10937516 (Publication Type: Clinical Trial, Controlled Clinical Trial, Journal Article, Multicenter Study)

Chemical References

• Placebos
• Platelet Aggregation Inhibitors
• Dilazep

Topics

• Albuminuria (pathology)
• Blood Pressure
• Diabetic Nephropathies (drug therapy, physiopathology, urine)
• Dilazep (pharmacology, therapeutic use)
• Female
• Humans
• Male
• Middle Aged
• Placebos
• Platelet Aggregation Inhibitors (pharmacology, therapeutic use)
• Reference Values
• Urine (cytology)
• Urothelium (drug effects)