[The effect of glycosaminoglycan sulodexide on albuminuria in patients with diabetes mellitus].
BACKGROUND
Experimental and clinical studies showed a decrease in albuminuria, a marker of diabetic nephropathy after administration of heparin or other glycosaminoglycans (GAG).


OBJECTIVE
To study the effect of sulodexide on albumin excretion rate (AER) in patients with type 1 or type 2 diabetes mellitus (DM).


METHODS
Twenty patients (12 of type 1 DM) aged 33-63 yrs (median 45) with microalbuminuria (AER 20-200 micrograms/min) or macroalbuminuria (AER > 200 micrograms/min) were enrolled in open study and received sulodexide 60 mg/day i.m. for 3 weeks with further 6-week follow-up without treatment. In the 2nd phase, sulodexide 100 mg/day was given p.o. for 8 weeks with further 8-weeks follow-up. Albuminuria in overnight urine samples was analyzed by the RIA method and results (medians with lower and upper quartiles) were compared by the Wilcoxon test.


RESULTS
In the 1st phase, AER (microgram/min) decreased from 167 (54-378) at baseline to 118 (78-220) at week 1 (p < 0.05), 105 (68-341) at week 2 (p < 0.05), and to 114 (56-354) at week 3 (NS). After stopping the treatment, AER gradually raised to baseline values. During the oral phase, AER decreased from 253 (37-961) to 137 (35-323) after 1 month (p < 0.05) and to 144 (47-588) after 2 months (NS). This effect was prolonged for further 2 months after treatment withdrawal (AER 110 (65-363) micrograms/min, p < 0.05). In both phases, the decrease in AER was shown only in patients with macroalbuminuria, but not in those with microalbuminuria. Blood pressure, glomerular filtration rate and metabolic compensation of DM were not changed.


CONCLUSIONS
A short-term treatment with sulodexide i.m. or p.o. significantly decreased albuminuria in DM patients. This effect was prolonged for further 2 months after oral administration. Therefore, sulodexide could be useful in the treatment of diabetic nephropathy. (Tab. 3, Ref. 20.)
Oksa
A
A
Department of Pharmacotherapy, Institute of Clinical and Preventive Medicine, Bratislava, Slovakia. oksa@upkm.sk
Pontuch
P
P
Kratochvilova
H
H
D000328:Adult; D000419:Albuminuria; D003920:Diabetes Mellitus / Q000188:drug therapy / Q000652:urine*; D005260:Female; D006025:Glycosaminoglycans / Q000627:therapeutic use*; D006801:Humans; D007004:Hypoglycemic Agents / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged
D006025:Glycosaminoglycans; D007004:Hypoglycemic Agents; C007858:glucuronyl glucosamine glycan sulfate