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Submitted: 11 May 2020
Accepted: 30 Jun 2020
ePublished: 01 Aug 2020
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J Nephropharmacol. 2021;10(2): e10.
doi: 10.34172/npj.2021.10
  Abstract View: 29
  PDF Download: 8

Original

The effects of sevelamer carbonate on blood glucose and inflammatory factors in patients with diabetic kidney disease; a controlled clinical trial

Shadi Botshekan 1 ORCID logo, Leila Mahmoodnia 1 * ORCID logo, Ali Momeni 1 ORCID logo, Tina Jafari 2 ORCID logo, Ali Hasanpour Dehkordi 3 * ORCID logo, Mohammadsaleh Ghafari Goosheh 4 ORCID logo

1 Department of Internal Medicine, Faculty of Medicine, Shahrekord University of Medical Sciences, Shahrekord, Iran
2 Nutrition and Dietetics subspecialty, Faculty of Medicine, Shahrekord University of Medical Sciences, Shahrekord, Iran
3 Associate Professor, Social Determinants of Health Research Center, School of Allied Medical Sciences, Shahrekord University of Medical Sciences, Shahrekord, Iran
4 Department of Parasitology and Mycology, Faculty of Medicine, Shahrekord University of Medical Sciences, Shahrekord, Iran
Ali Hasanpour Dehkordi, Email: Alihassanpourdehkordi@gmail.com

Abstract

Introduction: Diabetic nephropathy (diabetic kidney disease) is a complication of diabetes that begins and progresses with several factors, including hyperglycemia, inflammation and oxidative stress.

Objective: This study demonstrates the effect of sevelamer carbonate administration on hemoglobin A1c levels, blood sugar and inflammatory factors in diabetic nephropathy patients. Patients and Methods: In this clinical trial, 48 diabetic patients under treatment of least one drug who have proteinuria (urinary protein to creatinine ratio greater than 0.5) ≥ 2 times during the past 18 months, received sevelamer carbonate or placebo for two months. Patients’ blood samples were taken before and after the intervention. Data were analyzed by SPSS software.

Results: According to the results, fasting blood sugar (FBS), hemoglobin A1c (HbA1c), erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) showed no significant difference between the study groups before and after the intervention (P>0.05). The mean ICAM-1(intercellular adhesion molecule-1) and VCAM-1 (vascular cell adhesion molecule1) showed no significant difference between the study groups before the intervention (P>0.05). However we found a meaningful difference after the intervention, which was significantly lower in the intervention group (P<0.05).

Conclusion: Sevelamer carbonate administration in patients with diabetic nephropathy has a significant effect on decreasing ICAM-1 and VCAM-1 levels.

Trial registration: The trial protocol was approved in the Iranian Registry of Clinical Trial (identifier: IRCT20191111045401N1; https://en.irct.ir/trial/43662, ethical code; IR.SKUMS. REC.1397.181).

Keywords: Hemoglobin A1c, Inflammatory factors, Diabetic nephropathy, Sevelamer carbonate diabetic, Kidney disease, Chronic kidney disease, End-stage renal disease

Implication for health policy/practice/research/medical education:

Various risk factors such as elevated blood sugar, oxidative stress, elevated concentration of advanced glycosylation end-products and inflammation are involved in diabetic nephropathy. Sevelamer carbonate is a phosphate binding drug that has been proven to have anti-inflammatory and hypoglycemic effects. In our clinical trial, treatment of diabetic nephropathy patients with sevelamer carbonate led to a significant decrease of ICAM-1 (intercellular adhesion molecule-1) and VCAM-1 (vascular cell adhesion molecule1) adhesion molecules which suggests the role of sevelamer carbonate in the recovery of endothelial dysfunction.

Please cite this paper as: Botshekan S, Mahmoodnia L, Momeni A, Hasanpour Dehkordi A, Ghafari Goosheh M. The effects of sevelamer carbonate on blood glucose and inflammatory factors in patients with diabetic kidney disease; a controlled clinical trial. J Nephropharmacol. 2021;10(2):e10. DOI: 10.34172/npj.2021.10.

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