title: [Clinical efficacy and safety of sequential treatment with alprostadil and beraprost sodium for chronic renal failure induced by chronic glomerulonephritis].
abstract: OBJECTIVE
  To evaluate the clinical efficacy and safety of sequential treatment with alprostadil and beraprost sodium for chronic renal failure caused by chronic glomerulonephritis.
  
  
  METHODS
  Sixty-three patients with chronic renal failure due to chronic glomerulonephritis, after receiving a 2-week-long conventional treatment, were randomly divided into alprostadil group (n=20, with alprostadil injection at 10 µg/d for 2 weeks), sequential treatment group (n=21, with alprostadil injection at 10 µg/d for 2 weeks and oral beraprost sodium at 20 µg three times a day for 12 weeks), and strengthened sequential treatment group (n=22, with alprostadil injection at 20 µg/d for 2 weeks and a double dose of oral beraprost sodium for 12 weeks). Urinary albumin excretion rate (UAER), cystatin C (Cys C), blood urea nitrogen, creatinine, fibrinogen, D-dimer, prothrombin time (PT), and platelets were tested before and after the treatment, and the changes in urinary albumin discharge rate, serum creatinine, and glomerular filtration rate were determined.
  
  
  RESULTS
  The patients in strengthened sequential treatment group showed a significantly decreased change rate of urinary albumin discharge rate (P<0.01) than those in the other two groups. In the two sequential treatment groups, especially the strengthened treatment group, the change rate of glomerular filtration rate increased significantly compared with that in alprostadil group (P<0.01). Strengthened sequential treatment resulted also in significantly decreased increment of serum creatinine compared that in the other 2 groups (P<0.01). After 14 weeks of treatment, fibrinogen and D-dimer were decreased in all the 3 groups (P<0.05) to a comparable level between the 3 groups (P>0.05), and prothrombin time (PT) or platelet showed no significant changes (P>0.05).
  
  
  CONCLUSIONS
  Sequential treatment with alprostadil and beraprost sodium can improve the glomerular filtration rate and decrease urine albumin excretion rate, serum creatinine increase rate, and lower blood fibrinogen and D-dimer levels, thus delaying the progression of chronic renal failure caused by chronic glomerulonephritis. This therapy shows a dose-related effect with good clinical safety.
authors.affiliation: Department of Nephrology, First Affiliated Hospital of Fujian Medical University, Fuzhou 350005, China. E-mail: chinaalec@tom.com.
authors.forename: Yi
authors.initials: Y
authors.lastname: Chen
authors.forename: Jian-Xin
authors.initials: JX
authors.lastname: Wan
authors.forename: De-Wen
authors.initials: DW
authors.lastname: Jiang
authors.forename: Bin-Bin
authors.initials: BB
authors.lastname: Fu
authors.forename: Jiong
authors.initials: J
authors.lastname: Cui
authors.forename: Gui-Fen
authors.initials: GF
authors.lastname: Li
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000527:Alprostadil / Q000627:therapeutic use*; D001806:Blood Urea Nitrogen; D002908:Chronic Disease; D003404:Creatinine / Q000097:blood; D004359:Drug Therapy, Combination; D011464:Epoprostenol / Q000031:analogs & derivatives* / Q000627:therapeutic use; D005260:Female; D005338:Fibrin Fibrinogen Degradation Products / Q000378:metabolism; D005340:Fibrinogen / Q000378:metabolism; D005919:Glomerular Filtration Rate; D005921:Glomerulonephritis / Q000150:complications*; D006801:Humans; D007676:Kidney Failure, Chronic / Q000097:blood / Q000188:drug therapy* / Q000209:etiology; D008297:Male; D008875:Middle Aged; D010975:Platelet Aggregation Inhibitors / Q000627:therapeutic use; D010976:Platelet Count; D011517:Prothrombin Time; D064804:Urological Agents / Q000627:therapeutic use; D055815:Young Adult
chemical_list: D005338:Fibrin Fibrinogen Degradation Products; D010975:Platelet Aggregation Inhibitors; D064804:Urological Agents; C036309:fibrin fragment D; C048081:beraprost; D005340:Fibrinogen; D003404:Creatinine; D011464:Epoprostenol; D000527:Alprostadil