Compelling experimental evidence exists for the role of oxidants and iron in glomerular disease. In preliminary studies, we confirmed increased urinary catalytic iron in patients with glomerulonephritis and diabetic nephropathy. We conducted two separate single-center, prospective, single-armed, open-labeled, proof-of-concept studies to evaluate the safety and efficacy of an oral iron chelator in patients with glomerulonephritis and diabetic nephropathy. Study 1 comprised 15 patients with biopsy-proven glomerulonephritis who had persistent proteinuria despite treatment with steroids and/or cyclophosphamides. Study 2 comprised 38 adult patients with diabetic nephropathy. Patients in Study 1 were treated with deferiprone (50 mg/kg/day) in three divided doses for 6 months and Study 2 patients were treated for 9 months. In Study 1, two patients had severe gastrointestinal intolerance and withdrew from the study after one dose and are not included in the results. There was a significant reduction (47 ± 9% mean) in 24-h urinary protein (4.01 ± 1.61 to 2.21 ± 1.62 [p = 0.009]), with no significant changes in serum creatinine. In Study 2, treatment with deferiprone resulted in a marked, persistent drop in the mean albumin/creatinine ratio (187 ± 47 at baseline to 25 ± 7 mg/g, [p = 0.01]) and stable renal function over a 9-month period. No clinically significant adverse events were observed in either study. Although these are small, open-labeled, and non-randomized studies, our results suggest that future randomized, double-blind trials examining the utility of deferiprone to treat glomerular diseases appear warranted.
Background: Diabetes mellitus (DM) is a complex metabolic disorder portrayed by chronic hyperglycemia bringing about intricacies influencing the peripheral nerves, kidneys, eyes, and macrovascular structures. Mean platelet volume (MPV) is also considered to impact the advancement of microvascular complications of diabetes mellitus which has been looked for in this study. Aims and Objectives: The aims of this study were as follows: (1) To study association of MPV with Nephropathy and Retinopathy in Diabetes. (2) To Study correlation of MPV with hemoglobin A1c (HbA1C), fasting blood sugar, post-prandial blood sugar, and body mass index (BMI). Materials and Methods: This was an observational study conducted over 18 months period on patients (both males and females) seeking medical attention for newly diagnosed or previously diagnosed DM. Selective sampling technique was used and 200 diabetic patients were enrolled in the study during the study period. Results: (1) The incidence of retinopathy and increased Hba1c was significantly higher in poorly controlled diabetics as compared to controlled diabetics. (2) In good glycemic control group, mean MPV was 8.58 fL and, in poor glycemic control group, mean MPV was 10.21 fL. Conclusion: There was a positive correlation between MPV and HbA1C, microalbuminuria, BMI, fasting, and post-prandial blood sugar levels. There was no significant association between MPV and retinopathy.
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