title: Efficacy of long-term low-dose sulodexide in diabetic and non-diabetic nephropathies.
abstract: OBJECTIVE
  Sulodexide has been reported to have antiproteinuric and nephroprotective properties. We investigated the effects of long-term low-dose Sulodexide on proteinuria and renal function in patients with chronic kidney disease (CKD) caused by diabetic nephropathy (DN), hypertensive nephropathy (HN) and primary glomerulonephritis (GN).
  
  
  METHODS
  100 patients with CKD received low-dose Sulodexide 50 mg/day for 12 months. Treatment efficacy was evaluated as proteinuria reduction compared to baseline; response was defined as a decline in proteinuria below 0.3 g/d. Renal function evolution was assessed by eGFR variation from baseline.
  
  
  RESULTS
  All patients presented reduction of proteinuria, with global mean value of proteinuria decrease of 0.85 +/- 1.34 g/d (p<0.0001). Patients with HN had the highest mean percentage of proteinuria reduction (73 +/- 29%) and the lowest mean time period to achieve responder status (6.6 +/- 2.4 months), compared to patients with DN (57 +/- 29%, 8 +/- 2.9 months) and GN (63 +/- 24%, 10.7 +/- 1.2 months). Renal function as mean eGFR remained stable or improved during the study; significant increase was found only in HN group (3.41 +/- 6.38 ml/min/1.73 m2, p=0.043). Multivariate regression analysis identified that responder status was significantly associated with gender, baseline eGFR, baseline proteinuria and etiology of CKD. Concomitant administration of ACEIs or/and ARBs did not influence the response to Sulodexide therapy.
  
  
  CONCLUSIONS
  Independently of ACEIs or/and ARBs therapy, long-term low-dose Sulodexide is efficient as antiproteinuric and renoprotective therapy in patients with CKD caused by DN, GN and HN. Better response is achieved in patients with lower degree of renal dysfunction.
authors.forename: Diana-Silvia
authors.initials: DS
authors.lastname: Zilişteanu
authors.forename: Teodora
authors.initials: T
authors.lastname: Atasie
authors.forename: M
authors.initials: M
authors.lastname: Voiculescu
mesh_terms: D000328:Adult; D000368:Aged; D000925:Anticoagulants / Q000494:pharmacology / Q000627:therapeutic use*; D003928:Diabetic Nephropathies / Q000188:drug therapy*; D005260:Female; D005919:Glomerular Filtration Rate / Q000187:drug effects; D005921:Glomerulonephritis / Q000188:drug therapy*; D006025:Glycosaminoglycans / Q000494:pharmacology / Q000627:therapeutic use*; D006801:Humans; D006977:Hypertension, Renal / Q000188:drug therapy*; D008297:Male; D008875:Middle Aged; D009393:Nephritis / Q000188:drug therapy*; D011446:Prospective Studies
chemical_list: D000925:Anticoagulants; D006025:Glycosaminoglycans; C007858:glucuronyl glucosamine glycan sulfate