title: Sulodexide therapy for the treatment of diabetic nephropathy, a meta-analysis and literature review.
abstract: Sulodexide is a heterogeneous group of sulfated glycosaminoglycans (GAGs) that is mainly composed of low-molecular-weight heparin. Clinical studies have demonstrated that sulodexide is capable of reducing urinary albumin excretion rates in patients with type 1 and type 2 diabetes, suggesting that sulodexide has renal protection. However, this efficacy remains inconclusive. In this article, we used meta-analysis to summarize the clinical results of all prospective clinical studies in order to determine the clinical efficacy and safety of sulodexide in diabetic patients with nephropathy. Overall, sulodexide therapy was associated with a significant reduction in urinary protein excretion. In the sulodexide group, 220 (17.7%) achieved at least a 50% decrease in albumin excretion rate compared with only 141 (11.5%) in the placebo. The odds ratio comparing proportions of patients with therapeutic success between the sulodexide and placebo groups was 3.28 (95% confidence interval, 1.34-8.06; P=0.01). These data suggest a renoprotective benefit of sulodexide in patients with diabetes and micro- and macroalbuminuria, which will provide important information for clinical use of this drug as a potential modality for diabetic nephropathy, specifically, the prevention of end-stage renal disease that is often caused by diabetes.
authors.affiliation: Emergency Department, First Affiliated Hospital of Dalian Medical University, Dalian, People's Republic of China.
authors.forename: Rui
authors.initials: R
authors.lastname: Li
authors.affiliation: Emergency Department, First Affiliated Hospital of Dalian Medical University, Dalian, People's Republic of China.
authors.forename: Jing
authors.initials: J
authors.lastname: Xing
authors.affiliation: Dalian Hospital of Traditional Chinese Medicine, Dalian, People's Republic of China.
authors.forename: Xaojing
authors.initials: X
authors.lastname: Mu
authors.affiliation: Emergency Department, First Affiliated Hospital of Dalian Medical University, Dalian, People's Republic of China.
authors.forename: Hui
authors.initials: H
authors.lastname: Wang
authors.affiliation: Intensive Care Unit, Tianjin First Central Hospital, People's Republic of China.
authors.forename: Lei
authors.initials: L
authors.lastname: Zhang
authors.affiliation: Emergency Department, First Affiliated Hospital of Dalian Medical University, Dalian, People's Republic of China.
authors.forename: Yu
authors.initials: Y
authors.lastname: Zhao
authors.affiliation: Emergency Department, First Affiliated Hospital of Dalian Medical University, Dalian, People's Republic of China.
authors.forename: Yu
authors.initials: Y
authors.lastname: Zhang
mesh_terms: D002986:Clinical Trials as Topic; D003922:Diabetes Mellitus, Type 1 / Q000150:complications* / Q000188:drug therapy; D003924:Diabetes Mellitus, Type 2 / Q000150:complications* / Q000188:drug therapy; D003928:Diabetic Nephropathies / Q000188:drug therapy* / Q000209:etiology*; D006025:Glycosaminoglycans / Q000627:therapeutic use*; D006801:Humans
chemical_list: D006025:Glycosaminoglycans; C007858:glucuronyl glucosamine glycan sulfate
keywords: diabetic nephropathy; meta-analysis; odds ratio; sulodexide