Özet:

Purpose: Proteinuria is one of the most important causes of the progression of kidney failure. Many studies have shown that angiotensin-transforming enzyme inhibitors (ACEI) and angiotensin receptor blocks (ARBs) reduce proteinure, but some patients do not have sufficient activity. Oral nitrates can reduce proteinuria by reducing intraglomerular pressure by glomerular vasodilation. In this study, the effect of oral isosorbid mononithrate (IMN) on the proteinure in patients with nefrotic syndrome was studied. 36 patients with nephrotic syndrome (proteinure >1 g/day) who have been using ACEI or ARB for at least 6 months, symptomatic ischemic heart disease causes, who have previously started IMN treatment, were taken to study. Results: All patients were evaluated together and a significant decrease in proteinure was observed after IMN treatment (p=0.02). While the IMN treatment in reducing proteinuria was effective in patients using ACE and ARB combined (p=0,01), it was not effective in patients using ACE alone or ARB alone (p=0,15). The IMN was also effective in diabetic patients (p=0,02), but it was not effective in non-diabetic patients (p=0,33). In patients using calcium channel blocks, the IMN was ineffective (p=0.96). A decrease in the protein was found associated with the basal proteinure level (p<0,001). Most of the young patients had a response to the IMN treatment (p=0,01). In the logistical regression analysis, those using age, basal proteinuria, ACEI, ARB, CCB, the presence of diabetes was included as independent variables. Only age and use of ACE were meaningful parameters. Result: Oral nitrate use may be effective in reducing proteinuria in patients with nefrotic syndrome. This effect was more noticeable in young diabetics who used ACE and ARB together.

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