Antiproteinuric effect of niceritrol, a nicotinic acid derivative, in chronic renal disease with hyperlipidemia: a randomized trial

Am J Med. 2003 Apr 1;114(5):347-53. doi: 10.1016/s0002-9343(02)01567-x.

Abstract

Purpose: Lipoprotein (a) [Lp(a)] levels increase in patients with renal disease. We administered niceritrol, a nicotinic acid derivative, to patients with chronic renal disease and a high serum Lp(a) level, and studied its effects on lipid metabolism, proteinuria, and renal function.

Methods: Thirty-three patients with chronic renal disease whose serum Lp(a) levels were > or = 15 mg/dL were randomly (but not blindly) assigned to treatment with niceritrol (n = 16) or to an untreated control group (n = 17). Parameters of lipid metabolism, excretion of urinary protein, and renal function were examined for 12 months.

Results: Changes in urinary protein excretion, as well as Lp(a) levels, differed significantly between the two groups. The mean (+/- SD) change from baseline in excretion of urinary protein was 0.77 +/- 1.23 g/d in the control group compared with -1.41 +/- 2.26 g/d in the niceritrol group at 12 months (P =0.003). Mean Lp(a) levels increased by 3 +/- 10 mg/dL in the control group compared with a decrease of 10 +/- 13 mg/dL in the niceritrol group at 12 months (P =0.004). The mean creatinine clearance declined by 10 +/- 12 mL/min in the control group, compared with 1 +/- 13 mL/min in the niceritrol group at 12 months (P =0.06).

Conclusion: Lipid levels improved with niceritrol treatment, whereas the excretion of urinary protein decreased, perhaps slowing the rate of loss of renal function in chronic renal disease.

Publication types

  • Clinical Trial
  • Randomized Controlled Trial

MeSH terms

  • Chronic Disease
  • Creatinine / metabolism
  • Disease Progression
  • Female
  • Humans
  • Hyperlipidemias / blood
  • Hyperlipidemias / complications*
  • Hyperlipidemias / drug therapy*
  • Hypolipidemic Agents / therapeutic use*
  • Kidney Diseases / complications*
  • Kidney Diseases / metabolism
  • Male
  • Middle Aged
  • Niceritrol / therapeutic use*
  • Proteinuria / prevention & control*

Substances

  • Hypolipidemic Agents
  • Creatinine
  • Niceritrol