Glycosaminoglycans in therapy of diabetic nephropathy

Abstract

Sulodexide, a drug containing glycosaminoglycans, was used in the treatment of patients with type I diabetes. Along with their effects on the blood clotting system, glycosaminoglycans are capable of preventing the mesangial proliferation and hyperproduction of extracellular matrix, as well as thickening of the glomerular basal membrane and impairment of its permeability and charge selection. A reliable antiproteinuric effect of the drug was noted, persisting for 6 weeks after it was discontinued; the excretion of protein with the urine reliably decreased in patients with both, microalbuminuria and proteinuria. Moreover, an antiatherogenic effect (a reliable decrease of serum atherogenicity coefficient) of sulodexide was observed. Assessment of the status of the fundus oculi of diabetics treated with sulodexide demonstrated a positive dynamics during therapy in some of the patients with nonproliferative and preproliferative retinopathy; no deterioration as regards the fundus oculi were noted. Hence, addition of sulodexide to combined therapy of patients with diabetic nephropathy is effective and pathogenetically justified.