The Effect of Probucol on Diabetic Nephropathy

D iabetic nephropathy is a major complication of diabetes. In the early stage, microalbuminuria is observed and followed by massive proteinuria. In the advanced stage, renal function decreases and uremia occurs. If nephropathy progresses, hemodialysis has to be initiated. Accordingly, suppressing the progression of diabetic nephropathy is important and urgent for the patient’s quality of life. Blood sugar control, blood pressure control and low protein intake are generally recommended as the standard of care for diabetic nephropathy. These treatments are effective in the early stage of diabetic nephropathy; they are hardly effective, however, in the advanced stage when increased serum creatinine occurs. Angiotensinconverting enzyme (ACE) inhibitors and angiotensin receptor antagonists have been reported to reduce the progression of diabetic nephropathy to some extent. Oxidative stress is a mechanism by which complications develops in diabetes. Probucol (Lorelco; not commercially available in the United States), developed as a cholesterollowering agent, has antioxidant effects. We hypothesized that probucol suppresses the progression of diabetic nephropathy through its antioxidant as well as its cholesterol-lowering effects. In this trial, we examined the effect of probucol on the progression of diabetic nephropathy.1