早期糖尿病性腎症に対するメシル酸カモスタットの臨床効果

抄録

We have studied the effect of camostat mesilate on microalbuminuria in patients with non-insulin-dependent diabetes mellitus. A randamised design was used. Forty three normotensive diabetic patients free of overt proteinuria were divided into two groups. One group was given camostat mesilate 300 mg/day and the other was treated as a control group. The age of the patients, the duration of diabetes, the glycemic control and the initial urinary albuminn excretion rate were matched in each group. Urinary albumin concentration was measured by RIA and the albumin creatinine ratio (ACR) was calculated to observe the effect of camostat mesilate on out patient clinic for six months.
In the group treated with camostat mesilate, ACR (mg/gCr) significantly (p>0.05) decreased from 75±50 to 53±43 (3 mo.) and to 37±20 (6 mo.). In those subjects with a relatively high ACR (ACR>100 mg/gCr), the decrease was more prominent with an average decrease of 65% after six months treatment. The control group showed no definite change in ACR through the six month period of observation. In conclusion, even short term treatment with camostat mesilate can reduce ACR in patients with incipient diabetic nephropathy. It is suggested that camostat mesilate caused a change in the glomerular capillary permeability for macromolecules through its inhibitory effects on the kallikrein-kinin system, complement system, coagulation system and platelet function.