GLYCOSAMINOGLYCAN SULODEXIDE DECREASES ALBUMINURIA IN DIABETIC-PATIENTS

Albuminuria is a dominant biochemical feature of developing diabetic n ephropathy. A disturbed metabolism of heparan sulphate characterized b y an increased loss of anionic charges in the basement membrane has be en considered as one of the main factors causing an increased albumin output into urine. All therapeutic approaches inducing a reduction of the albumin excretion rate (AER) have a protective effect on renal fun ction. The effect of glycosaminoglycan sulodexide on albuminuria was s tudied in a group of 53 diabetic patients (26 Type 1 and 27 Type 2) wi th micro and macroalbuminuria. Sulodexide (Vessel Due Fl was administe red intramuscularly in one daily dose (600 lipasemic units) for 3 week s followed by a 6 week wash-out period. A significant decrease of AER was found in a total cohort of patients following just 1 week of sulod exide treatment (mean 162 mu g/min, range 10-2708 mu g/min vs mean 248 mu g/min, range 20-3160 mu g/min, P < 0.001). This effect lasted 3-6 weeks after drug withdrawal. Similar results were obtained if Type 1 a nd Type 2 diabetic patients were evaluated separately but a delay of t he AER reduction was observed in the latter group. In all patients the mean AER was reduced to 60-65% of the initial values. A greater effec t of sulodexide on albuminuria was observed in patients with AER above 200 mu g/min than in those with microalbuminuria (a reduction to 47 v s 65% of the initial output). Sulodexide did not significantly reduce albuminuria in 28% of diabetic patients ('non-responders'). In conclus ion, glycosaminoglycan sulodexide may reduce AER in patients with micr o or macroalbuminuria and it could slow down development of diabetic n ephropathy. (C) 1997 Elsevier Science Ireland Ltd.