Glycosaminoglycans and renal function--basic and clinical aspects

Nowadays, the issue of application of conventional heparin and its low molecular weight (fractionated) forms in nephrological practice is still controversial. We summarize our own 12-year experience in the pathogenetic treatment of more than 140 in-patients with glomerulonephritis/glomerulopathy, consequently given low molecular weight and conventional heparin in two 10-day monotherapy courses, proven to be sufficient to control hypercoagulation and the activity of the acute process or a long-term manifestation of disease exacerbation. The patients were clinically observed and underwent detailed laboratory examinations before and after the applied therapy courses. The obtained data were statistically analyzed. LMWH has evident advantages over conventional heparin in the conservative treatment of patients with glomerulonephritis (regardless its morphologic form), with chronic renal failure of II-IV stages and concomitant arterial hypertension (mild and moderate/severe). Pathogenetic use of conventional heparin per se (given in 20-day courses) in such patients allows us to distinguish those requiring prolongation of conservative treatment from those who require "invasive" therapies (hemodialysis). Low molecular weight heparin treatment with approved doses represents a omising strategy of treatment of patients with glomerulonephritis and chronic renal failure being more effective than conventional eparin monotherapy, while no drug monitoring is needed.