Objective To assess the therapeutic effect of sulodexide for diabetic patients with early nephropathy. Methods A total of 60 patients with early diabetic nephropathy (albuminuria: 30 to 300 mg/24 h, male/female: 30/30, mean age: 51.23 years, mean course of disease: 12.9 years) were randomized equally into three groups: the routine treatment group, cozaar group (50 mg qd, po for 12 weeks) and sulodexid group (600 LSU qd, iv or im for 4 weeks, 250 LSU bid, po for 8 weeks). The levels of urinary albumin excretion rate (UAER), urea nitrogen and creatinine were determined. Results After three months of treatment, the level of UAER was decreased significantly in both the sulodexide group and cozaar group (Plt;0.01), but not in the routine treatment group (Pgt;0.05). The level of UAER was reduced by 34.04% and 33.62% in the cozaar group and the sulodexide group, respectively. Significant difference was noted in the level of UAER between the cozaar/sulodexide groups and the routine treatment group (Plt;0.01), but no significant difference was observed between cozaar group and sulodexide group (Pgt;0.05). Conclusion Sulodexide could decrease the level of UAER in patients with early diabetic nephropathy. It has similar efficacy to cozaar.
Objectives To explore the relationship between diabetic macular edema (DME) classified by different optical coherence tomography (OCT) types and the risk of diabetic nephropathy (DN). MethodsA retrospective clinical study. A total of 304 patients with DME, involving 421 eyes, diagnosed through ophthalmic examinations at Xi'an Third Hospital between August 2019 and December 2024 were included in the study. All affected eyes underwent OCT examination along with laboratory tests including glycated hemoglobin, serum albumin, serum creatinine, glomerular filtration rate, urine albumin-to-creatinine ratio, serum β2-microglobulin, and 24-hour urine protein quantification. Based on OCT imaging characteristics, DME was classified into diffuse retinal thickening (DRT) type, cystoid macular edema (CME) type, and serous retinal detachment (SRD) type, with corresponding group sizes of 96 patients (138 eyes), 102 patients (132 eyes), and 106 patients (151 eyes), respectively. The risk of DN development was categorized as low, moderate, high, or very high risk according to KDIGO guidelines. Intergroup comparisons of renal function-related indicators were performed using nonparametric tests. ResultsThe number of affected eyes classified as low risk for DN in the DRT, CME, and SRD groups were 87, 72, and 63, respectively. The number classified as moderate risk were 23, 23, and 28, respectively. The number classified as high risk were 22, 27, and 35, respectively. The number classified as extremely high risk were 6, 10, and 25, respectively. These differences were statistically significant (χ2=20.359, P=0.002). Serum albumin levels were (44.66±4.89), (43.59±6.41), and (41.31±7.53) g/L, respectively. Serum β2-microglobulin levels were (2.15±1.55), (2.52±2.34), and (4.09±5.57) mg/L, respectively. The 24-hour urine protein quantification was (94.88±64.58), (106.20±75.49), and (151.38±121.88) mg/24 h, respectively. Low serum albumin levels were (32.58±1.84), (31.58±2.13), and (30.15±1.63) g/L, respectively. 24-hour high urine protein levels were (225.15±59.78), (246.96±67.38), and (317.71±96.52) mg/24 h, respectively. High serum β2-microglobulin levels were (5.51±3.03), (7.80±3.63), and (14.60±6.81) mg/L, respectively. The comparison of indicators related to renal function showed that there were statistically significant overall differences among the three groups in serum albumin, serum β2-microglobulin and 24-hour urine protein quantification (χ2=18.367, 18.674, 14.612; P＜0.001). The SRD group presented more significant characteristics of renal function impairment. Its low serum albumin level was lower than that of the DRT and CME groups, while the 24-hour high urine protein quantification and high serum β2-microglobulin level were significantly higher than those of the other two groups, and the differences were statistically significant (χ2=21.587, 21.344, 21.587; P＜0.001). ConclusionDN is an important risk factor for SRD-type DME, and patients with this type often have more severe abnormal markers of renal function impairment.
