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Prostaglandins and diabetic nephropathy
1Third Department of Internal Medicine, Faculty of Medicine, Kyushu University, Fukuoka, Japan.
Journal of Diabetes and Its Complications
|October 1, 1995
Summary
Drugs modulating renal prostaglandins (PGs) improved diabetic nephropathy in patients with non-insulin-dependent diabetes mellitus (NIDDM). Treatments increased the 6-keto-PGF1 alpha (6KF) to TXB2 ratio, reducing albuminuria and improving creatinine clearance (Ccr).
Area of Science:
- Nephrology
- Endocrinology
- Pharmacology
Background:
- Abnormalities in renal prostaglandins (PGs) are implicated in diabetic nephropathy pathogenesis via altered renal hemodynamics.
- A decreased urinary excretion ratio of 6-keto-PGF1 alpha (6KF) to TXB2 is observed in patients with non-insulin-dependent diabetes mellitus (NIDDM).
Purpose of the Study:
- To evaluate the clinical effects of drugs modulating renal PG metabolism on diabetic nephropathy in NIDDM patients.
- To assess the impact of specific agents on urinary PG profiles and renal function markers.
Main Methods:
- Administration of ozagrel (thromboxane synthetase inhibitor), cilostazol (phosphodiesterase inhibitor), and beraprost sodium (PGI2 analogue) to NIDDM patients.
- Measurement of urinary 6-keto-PGF1 alpha (6KF), TXB2, albumin excretion, and creatinine clearance (Ccr).
Main Results:
- Ozagrel reduced urinary TXB2, improved the 6KF/TXB2 ratio, decreased albuminuria, and increased Ccr.
- Cilostazol demonstrated similar beneficial effects on renal parameters.
- Beraprost sodium reduced albuminuria, correlating with decreased platelet aggregation.
Conclusions:
- Modulating renal and platelet PGs to increase the 6KF/TXB2 ratio and inhibit platelet function may benefit diabetic nephropathy treatment.
- Ozagrel, cilostazol, and beraprost sodium show potential therapeutic value in managing diabetic nephropathy.