Effect of Candesartan on Creatinine and Albuminuria in Geriatric Patients with Diabetic Nephropathy

Luh Gede Sri Yenny; Ni Wayan Rusni

Authors

Luh Gede Sri Yenny Fakultas Kedokteran dan Ilmu Kesehatan Universitas Warmadewa
Ni Wayan Rusni Departemen Fisiologi dan Biokimia, Fakultas Kedokteran, Universitas Warmadewa

Keywords:

Candesartan, Creatinine, Proteinuria, Geriatrics, Diabetic Nephropathy

Abstract

Diabetic nephropathy (DN) is a major complication of diabetes, leading to proteinuria and declining kidney function. Candesartan, an angiotensin receptor blocker, may offer renal benefits beyond blood pressure control. Its specific effects on creatinine and proteinuria in geriatric DN patients remain underexplored. A cross-sectional study was conducted with 25 geriatric DN outpatients at Puri Raharja Hospital. Using consecutive sampling, subjects receiving 16 mg candesartan daily had their serum creatinine and proteinuria levels evaluated from medical records at baseline and after three months. The cohort (60-82 years) comprised 13 men and 12 women. Initial creatinine ranged from 0.80-2.60 mg/dL, with a final mean of 1.395 ± 0.50 mg/dL. Statistical analysis (paired T-test) showed no significant change in creatinine levels (p=0.892). However, proteinuria significantly decreased post-treatment (Wilcoxon test, p=0.005). Candesartan administration did not significantly reduce serum creatinine in geriatric DN patients over three months. However, the significant reduction in proteinuria indicates a beneficial effect on renal pathology, potentially slowing DN progression in this population.

References

Cahyani, P.A. et al. (2024) ‘Pengaruh Kadar HbA1c Pada Penderita Diabetes Melitus Tipe 2 Dengan Komplikasi Makrovaskular dan Mikrovaskular di Rumah Sakit Ibnu Sina YW UMI Makassar’, Jurnal Kesehatan Masyarakat, 8, pp. 4274–4281.

Ganesan, O. and Orgill, D.P. (2024) ‘An Overview of Recent Clinical Trials for Diabetic Foot Ulcer Therapies’, Journal of Clininical Medical, 1(2), pp. 1–17.

Horwitz, E.J. and Schelling, J.R. (2014) ‘Treatment of albuminuria due to diabetic nephropathy: recent trial results’, Clinical Investigation, 4(4), pp. 327–341. Available at: https://doi.org/10.4155/cli.14.19.

Imanudin, N., Kurniawan, M.F. and Rohmayanti, T. (2022) ‘Potensi Senyawa Aktif Ekstrak Kayu Manis Padang (Cinnamomum burmanii) sebagai Inhibitor Enzim Aldose Reductase secara Moleculer Docking Potential’, Jurnal Riset Sains dan Teknologi, 6(2), pp. 171–179.

Iswanto, E.D. and Silviani, Y. (2024) ‘HUBUNGAN KEJADIAN INFEKSI SALURAN KEMIH ( ISK ) DENGAN NILAI HBA1C PADA PASIEN PREDIABETES DAN DIABETES’, Jurnal Kesehatan Kusuma Husada Univesitas Kusuma Husada Surakarta, 15(1), pp. 62–70.

John, S. (2016) ‘Complication in diabetic nephropathy’, Diabetes & Metabolic Syndrome: Clinical Research & Reviews, 10(4), pp. 247–249. Available at: https://doi.org/10.1016/j.dsx.2016.06.005.

Kartono, T.H., Setiawan, D. and Astuti, I.Y. (2020) ‘Analisis Kepatuhan Minum Obat Anti Diabetik Terhadap Kadar Gula Darah Puasa Dan Nilai Hba1c Pada Pasien Diabetes Melitus’, Journal of Pharmacopolim, 3(3), pp. 166–173.

Lim, A. (2014) ‘Diabetic nephropathy – complications and treatment’, International Journal of Nephrology and Renovascular Disease, p. 361. Available at: https://doi.org/10.2147/IJNRD.S40172.

Mezil, S.A. and Abed, B.A. (2021) ‘Complication of Diabetes Mellitus’, Annals of the Romanian Society for Cell Biology, 25(3), pp. 1546–1556.

Mimran, A. and Alfaro, V. (2003) ‘Candesartan: Nephroprotective effects and treatment of diabetic nephropathy’, Drugs of Today, 39(6), p. 439. Available at: https://doi.org/10.1358/dot.2003.39.6.799449.

Mogensen, C.E. et al. (2000) ‘Randomised controlled trial of dual blockade of renin-angiotensin system in patients with hypertension, microalbuminuria, and non-insulin dependent diabetes: the candesartan and lisinopril microalbuminuria (CALM) study’, BMJ, 321(7274), pp. 1440–1444. Available at: https://doi.org/10.1136/bmj.321.7274.1440.

No, V. and Hartanto, A.D. (2023) ‘Pengurangan Dimensi dengan Metode Linear Discriminant Analist, 6(2), pp. 228–237.

Pecová, J. et al. (2023) ‘Clinical Efficacy of Hyaluronic Acid with Iodine in Hard-to-Heal Wounds’, Pharmaceutics. mdpi.com. Available at: https://doi.org/10.3390/pharmaceutics15092268.

Sharma, S. et al. (2015) ‘The role of melatonin in diabetes: Therapeutic implications’, Archives of Endocrinology and Metabolism, 59(5), pp. 391–399. Available at: https://doi.org/10.1590/2359-3997000000098.

Swedko, P.J. et al. (2003) ‘Serum Creatinine Is an Inadequate Screening Test for Renal Failure in Elderly Patients’, Archives of Internal Medicine, 163(3), p. 356. Available at: https://doi.org/10.1001/archinte.163.3.356.

Talari, P. et al. (2024) ‘Hybrid feature selection and classification technique for early prediction and severity of diabetes type 2’, Plus One, 1(1), pp. 1–17. Available at: https://doi.org/10.1371/journal.pone.0292100.