Effect of large-dose valsartan combined with sulodexide on urinary albumin excretion rate in patients with clinical-stage diabetic nephropathy

Objective To investigate the therapeutic effect of large-dose valsartan combined with sulodexide on urinary albumin excretion rate in patients with clinical-stage diabetic nephropathy.Methods A total of 120 cases of type 2 diabetes with clinical-stage diabetic nephropathy were randomly divided into four groups:group A(valsartan 80 mg qd,for 8 weeks);group B(valsartan 80 mg qd,po for 1 week,valsartan 320 mg qd,po for 7 weeks),group C(valsartan 80 mg qd,po for 1 week,valsartan 320 mg qd,po for 7 week and sulodexid 600 LSU qd,im for 4 weeks,sulodexid 250 LSU bid,po for 4 weeks) and group D(valsartan 80 mg qd,po for 1 week,valsartan 160 mg qd,po for 7 week and sulodexid 600 LSU qd,im for 4 weeks,sulodexid 250 LSU bid,po for 4 weeks).Four groups were treated with the same basic diet control and routine treatment,and the levels of urinary albumin excretion rate(UAER),serum urea nitrogen,serum creatinine,blood pressure and plasminogen activator inhibitor-1 were determined.Results After four-week treatment,the level of UAER was decreased significantly compared with that before treatment in C group(t=2.46,P0.05).After eight-week treatment,the levels of UAER in group B,C and D were decreased significantly compared with that before treatment(t=4.12,7.63,4.94,P0.05);the levels of UAER in group B,C and D were decreased significantly than that in group A(t=3.85,5.03,4.13,P0.05);the level of UAER in C group was decreased significantly than that in group B and D(t=2.93,3.17,P0.05);the levels of PAI-1 in group B,C and D had significantly differences before and after treatment(t=2.81,3.13,2.61,P0.05).Conclusions Large-dose(320mg) valsartan combined with sulodexide can decrease the level of UAER in patients with clinical-stage diabetic nephropathy safely and effectively and can protect renal function well.