Sulodexide therapy for the treatment of diabetic nephropathy, a meta-analysis and literature review

Abstract

Rui Li,1 Jing Xing,1 Xaojing Mu,2 Hui Wang,1 Lei Zhang,3 Yu Zhao,1 Yu Zhang1 1Emergency Department, First Affiliated Hospital of Dalian Medical University, 2Dalian Hospital of Traditional Chinese Medicine, Dalian, People’s Republic of China; 3Intensive Care Unit, Tianjin First Central Hospital, People’s Republic of China Abstract: Sulodexide is a heterogeneous group of sulfated glycosaminoglycans (GAGs) that is mainly composed of low-molecular-weight heparin. Clinical studies have demonstrated that sulodexide is capable of reducing urinary albumin excretion rates in patients with type 1 and type 2 diabetes, suggesting that sulodexide has renal protection. However, this efficacy remains inconclusive. In this article, we used meta-analysis to summarize the clinical results of all prospective clinical studies in order to determine the clinical efficacy and safety of sulodexide in diabetic patients with nephropathy. Overall, sulodexide therapy was associated with a significant reduction in urinary protein excretion. In the sulodexide group, 220 (17.7%) achieved at least a 50% decrease in albumin excretion rate compared with only 141 (11.5%) in the placebo. The odds ratio comparing proportions of patients with therapeutic success between the sulodexide and placebo groups was 3.28 (95% confidence interval, 1.34–8.06; P=0.01). These data suggest a renoprotective benefit of sulodexide in patients with diabetes and micro- and macroalbuminuria, which will provide important information for clinical use of this drug as a potential modality for diabetic nephropathy, specifically, the prevention of end-stage renal disease that is often caused by diabetes. Keywords: sulodexide, diabetic nephropathy, meta-analysis, odds ratio

Keywords

• Sulodexide
• Diabetic nephropathy
• Meta-analysis
• Odds ratio