Publication:
Addition of silymarin to renin-angiotensin system blockers in normotensive patients with type 2 diabetes mellitus and proteinuria: a prospective randomized trial

dc.contributor.coauthorVoroneanu, Luminita
dc.contributor.coauthorSiriopol, Dimitrie
dc.contributor.coauthorDumea, Raluca
dc.contributor.coauthorBadarau, Silvia
dc.contributor.coauthorAfşar, Barış
dc.contributor.coauthorGavrilovici, Cristina
dc.contributor.coauthorCovic, Adrian
dc.contributor.departmentSchool of Medicine
dc.contributor.kuauthorKanbay, Mehmet
dc.contributor.schoolcollegeinstituteSCHOOL OF MEDICINE
dc.date.accessioned2024-11-09T22:51:55Z
dc.date.issued2017
dc.description.abstractBackground : In the last decade, despite constant investigation, no current single treatment has been able to decrease the incidence of diabetic nephropathy and to significantly reduce progression of diabetic CKD. Methods : Patients with type 2 diabetes mellitus and proteinuria (> 0.5 g/day) after a screening and treatment optimization phase were randomly assigned to receive silymarin or placebo. The primary outcome was a composite outcome: mortality, decline of eGFR > 50% and renal replacement therapy. Secondary outcomes were a composite renal outcome (defined as a decline of eGFR >= 50% or ESRD) and also to test the effect of silymarin on the change in eGFR and proteinuria. We also assessed the adverse effects (hospitalizations, headache or gastrointestinal symptoms) during the study. Results : One hundred and two patients were included in the study. There were no significant differences between the two study groups regarding the primary and renal outcomes (HR 0.62, 95% CI 0.3-1.2, p = 0.15; HR 0.56, 95% CI 0.26-1.24, p = 0.16, respectively). At study end, eGFR declined significantly in both arms (p < 0.001), irrespective of the treatment group allocation, and there were no significant changes in proteinuria. There was a significant difference in hospitalizations rates between the two study groups (0.61, 95% CI 0.44-0.85). Conclusions : Silymarin did not show a significant reduction in the primary and secondary outcomes. Importantly, silymarin treatment was associated with a significant reduction in the hospitalization rate.
dc.description.indexedbyWOS
dc.description.indexedbyScopus
dc.description.indexedbyPubMed
dc.description.issue12
dc.description.openaccessNO
dc.description.publisherscopeInternational
dc.description.sponsoredbyTubitakEuN/A
dc.description.volume49
dc.identifier.doi10.1007/s11255-017-1697-5
dc.identifier.eissn1573-2584
dc.identifier.issn0301-1623
dc.identifier.quartileQ3
dc.identifier.scopus2-s2.0-85029819339
dc.identifier.urihttps://doi.org/10.1007/s11255-017-1697-5
dc.identifier.urihttps://hdl.handle.net/20.500.14288/6935
dc.identifier.wos414377800016
dc.keywordsSilymarin
dc.keywordsChronic kidney disease
dc.keywordsDiabetes mellitus
dc.keywordsProteinuria
dc.keywordsSurvival
dc.language.isoeng
dc.publisherSpringer
dc.relation.ispartofInternational Urology and Nephrology
dc.subjectUrology
dc.subjectNephrology
dc.titleAddition of silymarin to renin-angiotensin system blockers in normotensive patients with type 2 diabetes mellitus and proteinuria: a prospective randomized trial
dc.typeJournal Article
dspace.entity.typePublication
local.contributor.kuauthorKanbay, Mehmet
local.publication.orgunit1SCHOOL OF MEDICINE
local.publication.orgunit2School of Medicine
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relation.isParentOrgUnitOfPublication17f2dc8e-6e54-4fa8-b5e0-d6415123a93e
relation.isParentOrgUnitOfPublication.latestForDiscovery17f2dc8e-6e54-4fa8-b5e0-d6415123a93e

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