Telmisartan combined with calcitriol enhances therapeutic efficacy for diabetic nephropathy while inhibiting inflammation and renal interstitial fibrosis

Am J Transl Res. 2023 Nov 15;15(11):6543-6550. eCollection 2023.

Abstract

Purpose: This retrospective study aims to analyze the effect of telmisartan (TEL) combined with calcitriol (CTL) on therapeutic efficacy, inflammatory status, and renal interstitial fibrosis (RIF) in patients with diabetic nephropathy (DN).

Methods: First, 126 DN patients admitted between September 2019 and September 2022 were selected, of which 66 cases (research group) were treated with TEL + CTL, and 60 cases (control group) were given TEL alone. The therapeutic efficacy, complications (fever, dizziness, headache, nausea and vomiting, and gastrointestinal reactions), inflammatory status (interleukin (IL)-1β, high-sensitivity C-reactive protein (hs-CRP), and tumor necrosis factor (TNF)-α), RIF (transforming growth factor (TGF)-β1, vascular endothelial growth factor (VEGF), and homocysteine (Hcy)), and renal function (blood urea (BUN), serum creatinine (Cr), and microalbuminuria (mAlb)) were compared between the two groups. Finally, a univariate analysis was performed to identify factors leading to poor prognosis (ineffective treatment) in patients.

Results: A statistically higher overall response rate was determined in the research group as compared to the control group (P<0.05). The two groups exhibited equivalent complication rates (P>0.05). Markedly lower post-treatment IL-1β, hs-CRP, TNF-α, TGF-β1, VEGF, Hcy, BUN, Scr, and mAlb were identified in the research group than those in the control group (P<0.05). Moreover, hs-CRP, TNF-α, BUN, and treatment modality were found to be closely associated with poor prognosis in DN patients (P<0.05).

Conclusions: TEL + CTL has a good effect on DN and a comparable safety profile to TEL monotherapy. This combination can significantly inhibit inflammation and RIF and improve renal function in DN patients.

Keywords: Telmisartan; calcitriol; diabetic nephropathy; inflammatory status; therapeutic efficacy.