COMPARATIVE ANALYSIS ON RENAL FUNCTIONS IN BOTH INTERVENTION AND CONTROL GROUP AFTER ADMINISTRATION OF DOXYCYCLINE

Dr. Sushanta Kumar Barman*, Dr. Mohammad Nurul Islam khan, Dr. Monika Roy, Dr. Priobrata karmakar, Dr. Md. Abdul Kader Zilani, Dr. Md. Jahedul Islam and Dr. Ratindra Nath Mondal

ABSTRACT

Background: Diabetic nephropathy is one of the leading causes of ESRD. Activity of matrix metalloproteinases (MMPs), the enzymes primarily responsible for the deposition of extracellular matrix proteins, contributes to the pathogenesis of diabetic proteinuria. Doxycycline, a potent nonselective MMPs inhibitor, reduce proteinuria in diabetic patients. Objective: In this study our main goal is tocompare on renal functions, especially proteinuria in both intervention and control group after administration of Doxycycline. Method: This prospective interventional study was conducted at the Department of Nephrology in DMCH.The study included 60 clinically proven adult patients of DN. All patients were on optimal doses of angiotensin-converting enzyme inhibitors (ACEIs) or angiotensin receptor blockers (ARBs) for 2 months before the study. The patients were divided into two groups named control (group I, n = 30) and intervention group (group II, n = 30). Control group patients were maintained on optimal doses of ACEIs or ARBs, whereas intervention group patients received Doxycycline (100 mg/day) for a period of 3 months in addition to ACEIs or ARBs. Data were collected at month 0 and at month 1 at month 3. Results: Renal parameters were assessed at the beginning of the study, at month 1, at month 3. All renal parameters remained unaltered during the study in both groups. However, proteinuria showed improvement. The mean basal levels of 24 hours proteinuria was 2.2 ± 1.3g/day for Group I and 2.7 ± 1.42 g/day for Group II. P value is not significant in both group at baseline (p=0.2). Adequate glycemic control was achieved with insulin, oral hypoglycemic agents or both in all the patients. It reduced to 2.0 ± 1.2g/day for Group I and 2.5± 1.3g/day for Group II, at the end of 1 month. At the end of 3 months, a significant decline of proteinuria was observed in both the groups. In Group I it had a mean of 1.95 ± 1.2g/day, whereas it was 1.25± 0.78g/day in Group II. A statistically significant difference existed between the control and intervention groups (p < 0.05), at 3 months. Conclusion: In this study we can conclude that Doxycycline treatment in diabetic patients is capable of preventing progression of DN, instead of simply influencing one of its surrogate end points, albuminuria. Further long-term multicentric trials are required to determine the benefits of doxycycline in patients of DN.

Keywords: Doxycycline, diabetic nephropathy, Proteinuria, renal functions.