Decline in Glomerular Filtration Rate in Diabetes Patients Whom Treated with Angiotensin Converting Enzyme Inhibitor (ACEI)

Abstract

    Decline of renal function is one of the common complication in diabetes patients. Angiotensin converting enzyme inhibitor (ACEI) was recommended in these patients for preventing the progression of renal function in proteinuria cases. Some studies show regression of renal function after the use of ACEI in Chronic Kidney Disease (CKD)patients, but not in diabetes patients. A retrospective study,  reviewed 637 patients at Diabetes Out Patient Unit at PhraeHospitalduring 1 July, 2006to 31 August, 2006were studied. Glomerular Filtration Rate (GFR) was calculated by using abbreviated MDRD study equation. Decline in GFR was analyzed by using linear regression. 144 patients who used the ACEI along the 2 years period  were enrolled in this study. The mean age was 17-84 years (61.72±10.82), M:F was 58:86. Mean rate of decline in GFR  was -5.54±8.02 ml/min/1.73 m²/year. According to The Kidney Disease Outcomes Quality Initiative (KDOQI) classification, number of patients in CKD stage 1 was 32 and mean rate of decline in GFR in this group was -7.48±7.32 ml/min/1.73 m²/year; number of patients in CKD stage 2 was 86; decreasing of GRF was found in 68 patients(79.07%) at  -4.49±7.04 ml/min/1.73 m²/year and stable or increased in 18 patients (20.93%) at 4.71±4.36 ml/min/1.73 m²/year, number of patients in CKD stage 3 was 26; decreasing of GRF was found in 18 patients (69.23%) at -1.79±1.71ml/min/1.73 m²/year and stable or increased in   8 patients(30.77%) at 3.35±3.26 ml/min/1.73 m²/year.: Mean rate of decline in GFR in this study was -5.54±8.02 ml/min/1.73 m²/year. 26 patients did not show decline in GFR during this study. Patients whose GFR declined rapidly should be under close monitoring and regular follow-up was recommended.

Key words : Decline in glomerular filtration rate. Chronic kidney disease. ACEI.