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The Role of Sulodexide in the Treatment of Diabetic Nephropathy

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Abstract

Diabetic nephropathy is an important cause of morbidity and mortality in patients with either type 1 or type 2 diabetes mellitus. The pathogenesis and natural history of diabetic nephropathy, characterised by a progressive decline in glomerular function, were initially described in patients with type 1 diabetes. Reports that describe the glomerulopathy and progression of renal disease in patients with type 2 diabetes suggest that the disease process is similar to that observed in patients with type 1 diabetes with diabetic nephropathy. An emerging body of evidence supports the notion that glomerular capillary wall and mesangial alterations in diabetic nephropathy involve pathobiochemical alterations of glycoproteins in these structures. Evidence in experimental animals rendered diabetic, reveal that the administration of heparin and other anionic glycoproteins can effectively prevent the biochemical alterations that promote albuminuria. Clinical reports of the use of sulodexide, a preparation of low molecular weight glycosaminoglycan polysaccharides, have shown that proteinuria is significantly diminished in patients with diabetic nephropathy, even when these patients are receiving either an ACE inhibitor or angiotensin receptor antagonist.

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Acknowledgements

Dr Weiss has no conflicts of interest to declare. Dr Niecestro is a consultant to Keryx Biopharmaceuticals and is managing the global clinical-regulatory development of sulodexide for the treatment of diabetic nephropathy. Dr Raz is a consultant to Keryx Biopharmaceuticals, Johnson & Johnson, Merck, Sharpe & Dohme and Pfizer.

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  1. Diabetes Center, Hadassah Hebrew University School of Medicine, PO Box 12000, Jerusalem, 91120, Israel

    Ram Weiss & Itamar Raz

  2. Clinical Development Department, Keryx Biopharmaceuticals Inc., New York, New York, USA

    Robert Niecestro

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  1. Ram Weiss
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Weiss, R., Niecestro, R. & Raz, I. The Role of Sulodexide in the Treatment of Diabetic Nephropathy. Drugs 67, 2681–2696 (2007). https://doi.org/10.2165/00003495-200767180-00004

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