الفهرس 
Patlents and methodsOnly 14 pages are availabe for public view
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Abstract
The aim of this work is to study the effect of oral hypoglycemic sulfonylureas drugs on renal funct-ion in patients with long standing N..D.D.M.
The present study included 100 patients with long standing N.1.D.D.M. more than 5 years receiving tolbuta-mide with dose range between 500 to 1000 mg daily. The patients were 69 female and 31 male, with age range
from 38 to 65 years. They were first investigated for renal impairment guided by elevated serum creatinine above 1.5 mg/d1, with exclusion of apparent cause of renal impairment. Diabetic patients with impaired renal function were 11. Then, we studied the effect of tolbu-tamide withdrawal for 10 days on blood urea and serum creatinine which show insignificant decrease and on creatinine clearance which show insignificant increase. The effect of tolbutamide withdrawal for 20 days show significant decrease of blood urea and serum creatinine and significant increase of creatinine clearance.
The oral hypoglycemic sulfonylureas produce areversible impairment of renal function especially in patients with diabetic state more than 10 years. The
cause of reversibility of renal function changes may be due to their P.G synthesis inhibition.
from the study we recommened to check the serum area-tinine every 3 to 4 months in case of long term use of oral
sulfonylureas or earlier if another medical problem that may comprise renal perfusion developed as heart failure, ,
sever hypertension, liver cirrhosis with ascites and patients receivingdiuretics or N.S.A.I.D.