Abstract:
BACKGROUND:In the last decade, despite constant investigation, no current single treatment has been able to decrease the incidence of diabetic nephropathy and to significantly reduce progression of diabetic CKD. METHODS:Patients with type 2 diabetes mellitus and proteinuria (>0.5 g/day) after a screening and treatment optimization phase were randomly assigned to receive silymarin or placebo. The primary outcome was a composite outcome: mortality, decline of eGFR > 50% and renal replacement therapy. Secondary outcomes were a composite renal outcome (defined as a decline of eGFR ≥ 50% or ESRD) and also to test the effect of silymarin on the change in eGFR and proteinuria. We also assessed the adverse effects (hospitalizations, headache or gastrointestinal symptoms) during the study. RESULTS:One hundred and two patients were included in the study. There were no significant differences between the two study groups regarding the primary and renal outcomes (HR 0.62, 95% CI 0.3-1.2, p = 0.15; HR 0.56, 95% CI 0.26-1.24, p = 0.16, respectively). At study end, eGFR declined significantly in both arms (p < 0.001), irrespective of the treatment group allocation, and there were no significant changes in proteinuria. There was a significant difference in hospitalizations rates between the two study groups (0.61, 95% CI 0.44-0.85). CONCLUSIONS:Silymarin did not show a significant reduction in the primary and secondary outcomes. Importantly, silymarin treatment was associated with a significant reduction in the hospitalization rate.
journal_name
Int Urol Nephroljournal_title
International urology and nephrologyauthors
Voroneanu L,Siriopol D,Dumea R,Badarau S,Kanbay M,Afsar B,Gavrilovici C,Covic Adoi
10.1007/s11255-017-1697-5subject
Has Abstractpub_date
2017-12-01 00:00:00pages
2195-2204issue
12eissn
0301-1623issn
1573-2584pii
10.1007/s11255-017-1697-5journal_volume
49pub_type
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