The Effect of Pentoxifylline in Reducing Proteinuria in Patients with Diabetic Nephropathy Treated with ACEI or ARB

Background & objectives: Diabetes mellitus belongs to a group of common metabolic disorders characterized by hyperglycemia phenotypes. Diabetes mellitus causes secondary pathophysiological disorders in multiple organs of the body such as nephropathy, which causes many problems for patients and the health care system. In this study, the effect of pentoxifylline, a nonselective phosphodiesterase inhibitor, on reducing urinary protein excretion in diabetic patients was assessed. Methods: In this clinical trial, 72 diabetic patients with proteinuria who were admitted to the endocrine and nephrology clinic were selected and divided into two groups. Checklists, including demographic data, etc. were completed. In group (A), Angiotensin-converting enzyme inhibitors (ACEI) or Angiotensin II receptor blockers (ARBs) were prescribed to reduce proteinuria, and in another group (B), in addition to ACEI or ARB drugs, pentoxifylline was prescribed. In the end, the results in both groups were compared in terms of further reduction of proteinuria. Results: Most of the studied patients were male. There was a significant correlation between proteinuria (mean urinary protein excretion in 24 hours) and the effect of pentoxifylline on reducing proteinuria in patients with type II diabetes. Also, there was not a significant difference in systolic and diastolic blood pressure changes and HbA1c between the two groups at the beginning and end of the study. Conclusion: Pentoxifylline, independent of lowering blood pressure or reducing the improvement of metabolic control, can significantly decrease proteinuria and protein excretio

A Study of Carotid Arterial Intima-Media Thickness (IMT) Changes based on Clinical and Para-Clinical Indexes in Patients with Type 2 Diabetes

 Background & objectives: Ultrasonography as a non-invasive, inexpensive and generally available method has been used to measure of the intima-media thickness (IMT) of carotid arteries changes and finding its relationship with cardiovascular risk factors and vascular diseases. The aim of this study was to investigate the carotid arterial wall thickness (IMT) changes based on clinical and para-clinical indexes in patients with type 2 diabetes mellitus (DM). Methods: In this descriptive-analytical study, 100 patients with type 2 DM were randomly selected from all patients admitted to diabetes clinics and were considered in terms of clinical and paraclinical indexes of systemic atherosclerosis. Both types of IMT (TA and TB) were measured by ultrasonography in six locations of the carotid system. The intensity of these two values was calculated compared with the normal IMT and also, its relationship with clinical and para clinical indexes were determined. The results were statistically analyzed using SPSS software version 19.  Results: In this study, more than 80% of patients had IMT upper than normal. There was a significant difference between the severe increase of IMT and effective variables such as sex, smoking, physical inactivity, dyslipidemia and poor blood glucose control. Conclusions: This study showed that the DM and factors such as sex, smoking, physical inactivity had a significant effect on the increasing IMT compared to the normal range