The Therapeutic Effects of Sevelamer on Blood Sugar, HbA1c, Lipid Profile, and hs-CRP in Patients with Diabetic Nephropathy

摘要

Background: Diabetic nephropathy (DN) is one of the major complications of diabetes.Hyperglycemia, inflammation and oxidative stress as well as advanced glycation endproducts (AGEs) are reported as the risk factors for DN. Sevelamer has shown promisingresults in reducing inflammation and even HbA1c levels in DN.Objectives: We aimed to evaluate the therapeutic effects of sevelamer on blood sugar, HbA1clevel, lipid profile, and high sensitivity C-reactive protein (hs-CRP) in patients with DN.Patients and Methods: In this clinical trial, 18 patients (5 males and 13 females with meanage of 61.22±9.32 years) with stages 2-4 of DN were recruited. Patients were administeredwith 800 mg of sevelamer twice a day for 3 months. Blood sugar, HbA1c, hs-CRP, lipidprofile and other laboratory findings were measured before and 1, 2 and 3 months afterinitiation of the treatment.Results: There was a significant decline in HbA1c (P = 0.001), postprandial blood sugar(P <0.001) and phosphorus (P < 0.001) at the end of the study period. Sevelamer had noeffect on fasting blood sugar, lipid profile, blood urea nitrogen (BUN), creatinine, Na, Kand hs-CRP.Conclusions: Our results indicated that along with its phosphorus reducing effects, sevelamerplays an important role in decreasing postprandial blood sugar and HbA1c level. Sevelamerhad no effects on lipid profile and hs-CRP.