Comparative Study on Renoprotective Effect of Aliskiren-Pentoxifylline Combination, Valsartan and Enalapril Among Patients with Hypertension, Type 2 Diabetes Mellitus and Diabetic Nephropathy

This study was conducted to evaluate the renoprotective effect of aliskiren-pentoxifylline combination and compare it with enalapril and valsartan in patients with hypertension, type 2 diabetes mellitus and diabetic nephropathy (DN). Sixty patients with hypertension, type 2 diabetes mellitus and microalbuminurea (20- 200μg/min or 30-300mg/24h) were selected from UNRWA and private clinics in Gaza Strip and divided into three groups. The first group (n=20) was treated with enalapril (10-20mg/day), the second group (n=20) was treated with valsartan (160mg/day), whereas the third group (n=20) was treated with aliskiren-pentoxifylline combination (150,400mg/day). All patients were followed-up for nine months by measuring serum creatinine level and urinary albumin excretion (UAE) rate before and at 3, 6 and 9 months of treatment. Paired T-test and independent T-test were used to analyze our results and the significance was tested at p≤ 0.05. The results showed a significant reduction in both UAE rate and serum creatinine level among patients who used aliskiren-pentoxifylline combination after 6 and 9 months of treatment, where the reduction was highly significant after 9 months of treatment (p=0.001 for UAE, p=0.000 for serum creatinine level). In the valsartan treated group, the reduction in UAE rate was significant (p=0.045) after 9 months of treatment, while no significant reduction was noticed in serum creatinine level (p=0.807). Moreover, no significant reduction was seen in UAE rate (p=0.125) and serum creatinine level (p=0.445) among patients who were given enalapril. In conclusion, aliskiren-pentoxifylline combination showed renoprotective effect more distinct than enalapril and valsartan among patients with DN.