Pitavastatin Curbs Diabetic Nephropathy

Use of the new chemically synthesized agent pitavastatin appears to reduce tubulointerstitial damage in certain patients with diabetic nephropathy.

Dr. Hikaru Koide As senior investigator stated that, "pitavastatin can ameliorate injury in the renal tubules in patients with early diabetic nephropathy from the viewpoint of urinary fatty acid-binding protein excretion — an index of renal tubular injury."

Liver-type fatty acid binding protein (L-FABP) is expressed in renal proximal tubules and is reported to be a useful marker for progression of glomerulonephritis, Dr. Koide of Koto Hospital, Tokyo and colleagues explain. Using levels of L-FABP as a marker, the team initially studied 58 patients with type 2 diabetes and 20 healthy controls.

All of the diabetic patients except 12 without nephropathy showed significantly higher urinary L-FABP levels than did controls.
Of the diabetic patients, 20 with microalbuminuria were randomized to receive pitavastatin 1 mg per day or placebo.

At 12 months, in the active treatment group, urinary albumin excretion was significantly reduced from baseline (32 versus 110 mcg/minute). This was also true of L-FABP levels (8.8 versus 18.6 mcg/g creatinine). Little change was seen in placebo patients.

The researchers note that the effect was independent of cholesterol-lowering action, and they speculate that the results may be "in part due to reducing oxidative stress: however, the precise mechanisms remain unclear."

Summing up, they conclude that "urinary L-FABP levels appear to be associated with the progression of nephropathy, and pitavastatin may be effective in ameliorating tubulointerstitial damage."
Diabetes Care 2005;28:2728-2732.

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