Key result
Rosiglitazone fails to alter renal plasma flow response to ACE inhibition in type 2 diabetes.
Why the study?
Thiazolidinediones have been reported to improve early diabetic nephropathy independently of glycaemic control, and their effect on the intrarenal renin-angiotensin system was unclear.
Does rosiglitazone reduce renin-angiotensin system (RAS) activation in adult type 2 diabetic patients?
Does rosiglitazone reduce renin-angiotensin system (RAS) activation in adult type 2 diabetic patients?
Rosiglitazone does not appear to influence the renin-angiotensin system in patients with type 2 diabetes, suggesting its renal benefits are mediated through other mechanisms.
Answers are grounded in this paper and cite their sources.
Rosiglitazone does not alter RAS parameters in type 2 diabetes; leaves open non-RAS mechanisms for any renal effects.
BACKGROUND: Thiazolidinediones (TZD) have been reported to improve early stages of diabetic nephropathy independent of glycaemic control. Since blockade of the renin-angiotensin system (RAS) is known to reduce the risk of nephropathy, we hypothesised that the renal effect of TZDs might be related to a favourable effect on the intrarenal RAS. We aimed to determine if the TZD rosiglitazone could reduce RAS activation. METHODS: We studied adult type 2 diabetic patients and placed them on rosiglitazone for three months. We have previously used the renal haemodynamic response to angiotensin-converting enzyme (ACE) inhibition to demonstrate the state of RAS activation, and thus measured renal plasma flow (RPF) and glomerular filtration rate (GFR) before and after administration of captopril at 0 month and at three months. Plasma renin activity (PRA), active renin, aldosterone and natriuretic peptides were analysed. RESULTS: The RPF response to ACE inhibition was not altered. There was no change in GFR, PRA, active renin and aldosterone levels. Two patients developed oedema one had an elevated baseline active renin and another had an elevated baseline aldosterone level. CONCLUSION: The favourable effects of TZDs on diabetic nephropathy is likely not related to an influence on the RAS.
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Lansang et al. (2006) studied Type 2 diabetes. Rosiglitazone vs. Baseline (0 months) was evaluated on Renal plasma flow (RPF) response to ACE inhibition (captopril). Rosiglitazone treatment for three months did not alter the renal plasma flow response to ACE inhibition or change GFR, plasma renin activity, and aldosterone levels in type 2 diabetic patients.
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