Sulodexide for diabetic nephropathy complicated by retinopathy: A clinical observation

Objective While the therapeutic means and efficacy remain inadequate in the treatment of diabetic nephropathy(DN) complicated by diabetic retinopathy(DR),Sulodexide is shown to act on the common basis of the two pathological processes.The purpose of this study is to investigate the efficacy and safety of Sulodexide for patients with DN complicated by DR.Methods This study included 60 cases of type 2 DN complicated by DR confirmed by ophthalmofunduscopy and the 24 h urinary albumin excretion rate(UAER,30-300mg),32 males and 28 females,aged 32-70 years and with a diabetic history of 2.5-26 years.The patients were equally divided into a control and a Sulodexide group.The former received intravenous drip of Prostaglandin E1 at 10 μg qd combined with oral Irbesartan at 150mg qd for 2 weeks,followed by oral Difrarel at 0.4g tid combined with oral Irbesartan at 150mg qd for 14 weeks,while the latter was treated by intravenous drip of Sulodexide at 600 LSU qd for 4 weeks,and then orally at 250 LSU bid for 12 weeks.At 16 weeks after the initiation of medication,comparisons were made between the two groups in the changes of UAER,results of funduscopic examination,fasting plasma glucose(FPG),glycosylated hemoglobin(HbAlc),alanine aminotransferase(ALT),aspartate aminotransferase(AST),creatinine(Cr),and fibrin original(FIB).Results UAER was decreased from(150.06±80.79) mg/24h before the treatment to(93.3±52.33) mg/24h after it in the control group,and from(137.71±74.15) mg/24h to(91.70±61.89) mg/24h in the Sulodexide group,with significant differences in both of the groups(P0.01).At 16 weeks,however,UAER was reduced by 56.76 mg/24 h in the control and 46.01 mg/24 h in the Sulodexide group,with no significant differences between the two groups(P0.05).Ophthalmofunduscopy showed no significant differences in the grade of fundus oculi lesion either between the two groups or before and after the medication(P0.05),nor were there any significant differences in FPG,HbAlc,ALT,AST,r-GT,BUN,Cr and FIB before and after the treatment in either of the groups. Conclusion Sulodexide can reduce UAER in type 2 DN patients with microalbuminuria and retard the progression of DN and DR.