Effects on Urinary Albumin Excretion and Renal Function Changes by Delapril and Manidipine in Normotensive Type 2 Diabetic Patients with Micro albuminuria
CHAICHARN DEEROCHANAW ONG, M.D.*, PATTRAPORN KORNTHONG, R.N.*,
SUGUNYA PHONGWIRATCHAI, B.Sc.*, SUMONTHA SERIRAT, M.D.*
Affiliation : * Diabetes and Endocrinology Unit, Department of Medicine, Rajavithi Hospital, Department of Medical Services,
Ministry of Public Health, Bangkok 10400, Thailand.
AbstractThis study was designed to investigate the effect of delapril, an ACE inhibitor, and
manidipine, a long action calcium antagonist, on persistent microalbuminuria in normo
tensive type 2 diabetic patients. Sixty type 2 diabetic patients were randomized to take
delapril 30 mg/day or manidipine 10 mg/day for 48 weeks, in an open label design. Twenty
eight of thirty subjects in the delapril group and twenty nine of thirty in the manidipine
group completed the study. Urine albumin excretion as measured by the urinary albumin
creatinine ratio decreased significantly in both groups (112.0±60.9 to 95.3±64.9 mg/g and
108.5±51.0 to 96.4±53.5 mg/g in the delapril and manidipine group respectively, p < 0.05,
by paired t-test). Systolic and diastolic blood pressure were not significantly changed
after treatment in the delapril group but significantly decreased in the manidipine group
(130.9±7.1/80.2±6.1 to 127.2±7.1178.0±5.3 mm/Hg, p < 0.05, by student's paired t-test).
After 48 weeks of treatment, two patients in the delapril group and one patient in the
manidipine group converted to normoalbuminuria (urinary albumin:creatinine ratio < 30
mg/g) and one patient in each group progressed to overt nephropathy (urinary albumin:
creatinine ratio > 300 mg/g). There were no significant changes in fasting plasma glucose,
HbA1c, serum fructosamine, creatinine, potassium and lipid profiles after 48 weeks of
treatment in both groups. Two cases in the delapril group were withdrawn during the
study because of an intolerable cough and one case in the manidipine group because
of intolerable dizziness and headache. In conclusion, both delapril and manidipine are
effective in the reduction of microalbuminuria in normotensive type 2 diabetic patients
with persistent microalbuminuria.
Keywords : Type 2 Diabetes, Microalbuminuria, Normotension, Delapril, Manidipine
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