To discuss the curative effects of alfacalcidol combined with losartan potassium tablets in the treatment of early diabetic nephropathy (EDN).

90 EDN patients in our hospital were chosen and randomly divided into the observation group and control group (45 cases in each group). The control group was given losartan potassium tablets treatment, while the observation group was given alfacalcidol combiend with telmisartan treatment.All the two groups were treated for 3 months.Before and after treatment, the fasting blood glucose (FBG), 24h urine trace albumin quantitative (UAER), 24h urine protein (24h pro), serum creatinine (SCr), 25-hydroxyl vitamin D[25 (OH) D], blood calcium (Ca²⁺ ), potassium (K⁺ ), glycosylated hemoglobin (HbA1C) and serum inflammatory factors[C-reactive protein (CRP), tumor necrosis factor alpha (TNF-α), interleukin-6 (IL-6)]were observed, and the correlation between 25(OH)D and UAER, 24h pro was analyzed.At the same time, the clinical curative effects and adverse reactions during treatment were evaluated.

In the observation group, the total effective rate was 93.3%, which was significantly higher than 71.1% in the control group (χ²=7.601, P<0.05). In the two groups after treatment, the FBG, HbA1c, blood Ca²⁺ and K⁺ had no significant changes (all P>0.05). After treatment, Scr, 24h pro and UAER in the two groups were all significantly reduced compared with before treatment (P<0.05), and 24h pro and UAER in the observation group were significantly lower than those in the control group (t=6.296, 11.530, all P<0.05), but Scr had no statistically significant difference between two groups (t=0.331, P>0.331). After treatment, 25(OH)D in the observation group decreased significantly compared with before treatment (t=12.000, P<0.05), which was significantly higher than that in the control group after treatment (t=11.278, P<0.05). Compared with before treatment, 25(OH)D in the control group had no significant change after treatment (t=0.436, P>0.436). Pearson correlation analysis showed that 25(OH)D level was negatively correlated with 24h pro and UAER (r=0.483, 0.778, all P<0.05). In the two groups after treatment, the CRP, TNF-α and IL-6 levels significantly reduced (P<0.05), which in the observation group decreased more obviously (all P<0.05). In the two groups, no serious adverse events were found, the difference was not statistically significant (χ²=0.212, P>0.151).

Alfacalcidol combined with losartan potassium tablets can significantly reduce the proteinuria levels of EDN patients and inflammation, which has better clinical curative effects and higher safety.

Early diabetic nephropathy; Alfacalcidol; Losartan potassium tablets