The efficacy of combination therapy with vasartan and alprostadil for diabetic nephropathy

Objective To explore the efficacy of vasartan combined with alprostadil for diabetic nephropathy. Methods 90 patients with diabetic nephropathy were randomly assigned to receive vasartan alone ( 80-120 mg daily ), alprostadil alone ( 10 ug daily ), or vasartan plus alprostadil ( 80-120 mg and 10 ug daily ) for four weeks ( 30 patients for each group ). Blood pressure ( BP ) was controlled be low 125/75 mmHg in all the patients. BP, 24-hour urinary protein, serum creatinine ( SCr ),blood urea nitrogen( BUN )were measured before and after treatment. Severe adverse reactions were noted.Results No severe adverse reactions occurred in all the patients. After 4-week treatment, levels of 24-hour urinary protein differed significantly among the three groups [from 3.3 ± 1.3 ( g/24h ) to 1.9 ± 0.8 ( g/24h ) in the combination group, 3.3 ± 1.2 ( g/24h ) to 2.6 ± 1.1 ( g/24h ) in valsartan group, 3.3 ± 1.1 ( g/24h ) to 2.7 ± 1.2 ( g/24h ) in alprostadil group; P＜0.05]. Urinary protein level was lower in the combination group than in both valsartan group and alprostadil group ( P＜ 0.05 ). Conclusions Valsartan and alprostadil can both reduce urine protein excretion in patients with diabetic nephropathy; and combination therapy is better than monotherapy with valsartan or alprostadil. Key words: Vasartan;  Alprostadil;  Diabetic nephropathy;  Efficacy