Telmisartan and Renal Perfusion in Patients With Metabolic Syndrome
Status:
Completed
Trial end date:
2009-12-01
Target enrollment:
Participant gender:
Summary
A major complication of diabetes mellitus is diabetic nephropathy. In previous studies the
investigators could demonstrate that in patients with type 2 diabetes mellitus despite
unaltered basal and stimulated nitric oxide (NO) - activity, the renal response to the
antioxidant vitamin C was more pronounced compared to control subjects. These data suggest
that oxidative stress is increased in the renal vasculature of diabetic patients.
Furthermore, NO-activity in diabetic patients appears to be up regulated to compensate for
increase in oxidative stress. This hypothesis is supported by the demonstration of increased
endothelial nitric oxide synthase (eNOS) expression in kidney biopsies of diabetic patients.
Angiotensin receptor blockers have been found to reduce oxidative stress in various vascular
beds. Some drugs of this class, Telmisartan for example, also exhibit partial agonist
properties to the PPARγ receptor and might be of great benefit for patients with diabetes
mellitus or metabolic syndrome due to an additional improvement in insulin resistance.
Despite its effect on oxidative stress angiotensin receptor blockers beneficially alter renal
haemodynamics by reducing intraglomerular pressure and thus protect against glomerular
injury.
Recent advances in magnetic resonance imaging lead to the development of new techniques that
allow a separate measurement of renal medullar and cortical perfusion. This magnetic
resonance imaging technique might be a useful tool to detect alterations at an early level in
the kidneys of patients at high risk for diabetic nephropathy. In the current study, the
investigators want to evaluate the new magnetic resonance imaging technique by measuring
medullar and cortical renal perfusion before and after pharmacological intervention with
telmisartan in patients with metabolic syndrome.