PECULIARITIES OF NEPHROPROTECTIVE EFFECT OF SULODEXIDE IN PATIENTS WITH DIABETIC NEPHROPATHY

Abstract

Introduction. Monocyte chemoattractant protein type 1 (MCP-1) and plasminogen activator inhibitor type 1 (PAI-1) play a key role in inflammation, fibrosis and progression of renal dysfunction. Sulodexide advantages in vascular pathology treatment were proved by clinical trials, however, its efficiency in diabetic nephropathy (DN) was investigated insufficiently. The aim of the present work – to study the influence of sulodexide on clinical and laboratory parametres, MCP-1 and PAI-1 levels in blood plasma of patients with DN. Materials and methods. 76 type 2 diabetic patients with different stages of DN were observed. 44 patients received basic therapy with anti-diabetic drugs and ACE- inhibitors, 32 patients in addition to basic therapy were treated with sulodexide in a daily dose 600 LU. Concentrations of MCP-1 and PAI-1 in blood plasma were determined using immunoassay kits. Results. In patients with DN when compared with healthy controls MCP-1 and RAI-1 levels in blood plasma significantly increased already at initial stages of the disease. Such changes may promote a development of inflammatory and fibrotic processes in kidneys. Progression of the disease was accompanied by more essential growth of MCP-1 and RAI-1 in DN patients with expressed clinical manifestations of kidney injury. Sulodexide treatment in patients with DN resulted in essential decrease of inflammatory and fibrotic markers and had positive effect on urinary protein excretion. Conclusions. Glicosaminoglycans, in particular, sulodexide, is effective in complex treatment of patients with DN.

Keywords

• diabetic nephropathy, monocyte chemoattractant protein type 1, plasminogen activator inhibitor type 1, inflammation, fibrosis, sulodexide, microalbuminuria