Effects of Minocycline on Urine Albumin, Interleukin-6, and Osteoprotegerin in Patients with Diabetic Nephropathy: A Randomized Controlled Pilot Trial.
PLoS One
; 11(3): e0152357, 2016.
Article
em En
| MEDLINE
| ID: mdl-27019421
ABSTRACT
BACKGROUND:
We tested minocycline as an anti-proteinuric adjunct to renin-angiotensin-aldosterone system inhibitors (RAASi) in diabetic nephropathy (DN) and measured urinary biomarkers to evaluate minocycline's biological effects.DESIGN:
Prospective, single center, randomized, placebo-controlled, intention-to-treat pilot trial. Inclusion. Type 2 diabetes/DN; Baseline creatinine clearance >30 mL/min; proteinuria ≥1.0 g/day; Age ≥30 years; BP <150/95 mm Hg; intolerant of/at maximum RAASi dose. Protocol. 3-wk screening; Baseline randomization; Urine and blood measures at months 1, 2, 4, and Month 6 study completion. Urine interleukin-6 (IL-6) and osteoprotegerin were measured in a subset. Primary outcome. Natural log of urine protein/creatinine (ln U PCr) ratio at Month 6 vs Baseline.RESULTS:
30 patients completed the study. The 15% decline in U P Cr in minocycline patients (6 month PCr ÷ Baseline PCr, 0.85 vs. 0.92) was not significant (p = 0.27). Creatinine clearance did not differ in the 2 groups. Urine IL-6Cr (p = 0.03) and osteoprotegerin/Cr (p = 0.046) decrements were significant. Minocycline modified the relationship between urine IL-6 and proteinuria, suggesting a protective biological effect.CONCLUSIONS:
Although the decline in U PCr in minocycline patients was not statistically significant, the significant differences in urine IL-6 and osteoprotegerin suggest that minocycline may confer cytoprotection in patients with DN, providing a rationale for further study. TRIAL REGISTRATION Clinicaltrials.gov NCT01779089.
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Base de dados:
MEDLINE
Assunto principal:
Interleucina-6
/
Nefropatias Diabéticas
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Albuminas
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Osteoprotegerina
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Minociclina
Idioma:
En
Ano de publicação:
2016
Tipo de documento:
Article