Prevention of chronic glomerular uremia in steroid resistant glomerulonephritis. A clinical trial with a new antithrombotic agent.
To investigate the possibility of slowing down disease progression 27 patients with primary glomerular diseases unresponsive to steroids and cytotoxic drugs were treated with Defibrotide. This drug is a single stranded DNA fraction which has profibrinolytic and deaggregating properties and can promote the generation and release of prostacyclin from vascular tissue. Before treatment all patients showed proteinuria in excess of 1 g/day and 16 had a nephrotic syndrome (59%); 10 patients had serum creatinine above 1.6 mg/dl (37%) and 6 were hypertensive. After therapy a significant decrease in daily proteinuria was observed, although the reduction exceeded 50% of pre-treatment values in only 16 patients (59%). A progressive decrease in serum creatinine occurred in patients with abnormal renal function; serial measurement of renal plasma flow showed a progressive improvement with an average increase of 6 and 12%, after 1 and 3 months of treatment, respectively. These observations confirm the view that drugs improving endothelial function and renal hemodynamics can be of value in the treatment of chronic glomerular diseases and can contribute to the maintenance of renal function.
Institute of Nephrology, University of Bologna, Italy.
G M
GM
Frascà
A
A
Vangelista
D
D
Martella
M
M
Dondi
V
V
Bonomini
D000328:Adult; D002986:Clinical Trials as Topic; D005260:Female; D005343:Fibrinolytic Agents / Q000627:therapeutic use*; D005500:Follow-Up Studies; D005921:Glomerulonephritis / Q000188:drug therapy*; D006801:Humans; D008297:Male; D009404:Nephrotic Syndrome / Q000188:drug therapy; D011089:Polydeoxyribonucleotides / Q000627:therapeutic use*; D011507:Proteinuria / Q000188:drug therapy; D012079:Renal Circulation / Q000187:drug effects; D013997:Time Factors; D014511:Uremia / Q000517:prevention & control*
D005343:Fibrinolytic Agents; D011089:Polydeoxyribonucleotides; C036901:defibrotide