A Study on the Effect of Isosorbide Mononitrate on Proteinuria in Patients with Diabetic Nephropathy in a Tertiary Care Centre of West Bengal: A prospective interventional study

Abstract

Background: Diabetic nephropathy (DN) is a leading cause of end-stage renal disease. Proteinuria is a major prognostic marker in DN. Emerging evidence suggests that nitric oxide donors like isosorbide mononitrate (ISMN) may reduce proteinuria via renal vasodilation and endothelial modulation. Objective: To evaluate the effect of isosorbide mononitrate on proteinuria levels in patients with diabetic nephropathy in a tertiary care centre of West Bengal. Methods: A prospective interventional study was conducted on 34 patients with confirmed diabetic nephropathy. Baseline 24-hour urinary protein levels were recorded. Patients received isosorbide mononitrate (20 mg/day) for 12 weeks. Proteinuria levels were re-assessed at the end of the study period. Results: Mean baseline proteinuria was 1.8 ± 0.5 g/day. Post-treatment, a significant reduction was observed (mean 1.2 ± 0.4 g/day; p < 0.001). The reduction was more pronounced in patients with controlled blood pressure and shorter diabetes duration. Conclusion: Isosorbide mononitrate significantly reduced proteinuria in diabetic nephropathy patients. Its role as an adjunctive therapy in early diabetic kidney disease appears promising and warrants further studies with larger cohorts.