ILOPROST DECREASES URINARY ALBUMIN EXCRETION RATE IN PATIENTS WITH DIABETIC NEPHROPATHY

We conducted an open clinical trial to determine whether administratio n of iloprost, a stable prostacyclin analog, has any effect on urinary albumin excretion and other parameters associated with non-insulin-de pendent diabetes mellitus (NIDDM) patients. Twenty-three NIDDM patient s with nephropathy were divided into groups A and B which were matched in terms of sex, age, duration of diabetes and blood glucose control. After 2 weeks of observation, 11 patients in group A received an intr avenous infusion of iloprost (10 mu g at a rate of 0.075 mu g/kg per h ) once daily for 2 weeks, while 12 untreated diabetic patients in grou p B served as controls. In group A, iloprost significantly reduced the urinary albumin excretion rate, the urinary albumin-creatinine ratio and N-acetyl-beta-D-glucosaminidase without decreasing creatinine clea rance during the treatment period (P < 0.05, respectively). However, n one of these parameters changed significantly in group B. Urinary beta (2)-microglobulin, blood pressure, heart rate, serum electrolytes, BUN and serum creatinine were not significantly altered by iloprost durin g the treatment period. Side effects associated with iloprost were mil d and could be ameliorated by slowing the infusion rate. We conclude t hat iloprost appears to be safe and has an apparent effect on the urin ary albumin excretion rate and N-acetyl-beta-D-glucosaminidase.