Clinical observation of calcium dobesilate in the treatment of chronic renal allograft dysfunction

doi:10.3969/j.issn.2095-4344.2014.49.019

Abstract

Abstract:

BACKGROUND: Calcium dobesilate (calcium dihydroxy-2, 5-benzenesulfonate) has been widely used to treat chronic venous insufficiency and diabetic retinopathy, especially many clinical studies showed that calcium dobesilate as vasoprotective compound ameliorates renal lesions in diabetic nephropathy. However, there are few literatures reported calcium dobesilate in the treatment of chronic renal allograft dysfunction after renal transplantation.

OBJECTIVE: To observe the efficacy and safety of calcium dobesilate on chronic renal dysfunction after renal transplantation.

METHODS: A total of 152 patients with chronic renal allograft dysfunction after renal transplantation were enrolled from the Military Institute of Organ Transplantation, Changzheng Hospital, Second Military Medical University of Chinese PLA. They were randomly divided into the treatment group (n=78) and the control group (n=74). Patients in the treatment group received 500 mg of calcium dobesilate three times daily for eight weeks. All patients were treated with calcineurin inhibitor-based triple immunosuppressive protocols and comprehensive therapies.

RESULTS AND CONCLUSION: For patients receiving calcium dobesilate, serum creatinine, blood urea nitrogen and uric acid decreased significantly at two weeks after treatment and maintained a stable level (P < 0.05). However, serum creatinine and blood urea nitrogen returned to the original level soon after drug withdrawal. No significant difference was observed in blood cell count, liver function, blood lipids, electrolytes, blood pressure and 24-hour urine output between the two groups before and after therapy (P > 0.05). Administration of calcium dobesilate did not change the general condition of patients with renal insufficiency, nor did it affect blood concentrations of the immunosuppressive agents. Calcium dobesilate may help to delay the progress of graft injury in patients with chronic renal graft dysfunction by conjugating with creatinine, ameliorating the impaired microcirculation and its antioxidant property. The decline in serum creatinine alleviates patients’ anxiety and concern arising from the elevation of creatinine. However, the negative interference with serum creatinine caused by calcium dobesilate should be cautious in order to avoid misjudgment of patients’ condition.

中国组织工程研究杂志出版内容重点：肾移植；肝移植；移植；心脏移植；组织移植；皮肤移植；皮瓣移植；血管移植；器官移植；组织工程

全文链接：

Key words: calcium dobesilate, renal insufficiency, chronic, microcirculation, kidney transplantation

CLC Number:

R318

Zheng Xue-yang, Han Shu, Zhou Mei-sheng, Fu Shang-xi, Wang Li-ming. Clinical observation of calcium dobesilate in the treatment of chronic renal allograft dysfunction[J]. Chinese Journal of Tissue Engineering Research, 2014, 18(49): 7979-7984.

Figures/Tables 2

Quantitative analysis and clinical information of subjects A total of 152 chronic renal allograft dysfunction patients entered the final analysis. The general information and baseline data were shown in Table 1. There were no significant differences in demographic, disease duration, original renal function, and immunosuppressant administration between the two groups prior to treatment (P > 0.05). Effect of calcium dobesilate on renal function For patients receiving calcium dobesilate, serum creatinine, blood urea nitrogen and uric acid decreased obviously at the time of two weeks after treatment and maintained at a stable level (P < 0.05). The 24-hour urinary protein did not change much compared with the control group (P > 0.05; Table 2). However, serum creatinine and blood urea nitrogen in patients receiving calcium dobesilate returned to the original level quickly after discontinuation of the drugs (Table 2). Effect of calcium dobesilate on the other indicators According to blood routine, biochemical and other indicators were detected with the venous blood. No significant difference was observed in blood cell count, liver function, blood lipids and electrolytes between the two groups, or pre- and post-therapy in each group (P > 0.05; Table 3). Salt restriction, combination of antihypertensive drugs made the patients’ blood pressure under control, which had no significant difference in both groups (P > 0.05). The same situation was observed in the 24-hour urine output no matter calcium dobesilate use or not (P > 0.05; Table 3). Administration of calcium dobesilate did not change the general condition of patients with renal insufficiency, nor did it affect blood concentrations of the immunosuppressive agents (P > 0.05; Table 3). Adverse reactions of calcium dobesilate in chronic renal allograft dysfunction patients No adverse reactions were identified in the control group, but were observed in four (5%) of 78 patients in the treatment group, including a patient who had facial hot flush, which relieved spontaneously; three patients whose serum alanine transaminase elevated slightly, but returned to normal after administration of hepatoprotective drugs."

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