Efficacy of low-dose oral sulodexide in the management of diabetic nephropathy.

BACKGROUND: Diabetic nephropathy (DN) is the single greatest cause of end-stage renal disease (ESRD). Without specific interventions, microalbuminuria (incipient nephropathy) gradually progresses to macroalbuminuria (overt nephropathy) within 10-15 years in about 80% of type 1 and 30% of type 2 diabetic patients, and to ESRD within further 20 years in about 75% and 20%, respectively. A primary alteration in DN consists of decreased concentration of glycosaminoglycans (GAGs) in the glomerular extracellular matrix. This evidence has prompted interest in using exogenous GAGs and specifically sulodexide in DN treatment. PATIENTS AND METHODS: In this uncontrolled multicenter study, diabetic patients with albumin excretion rate (AER) >or=30 mg/24 hours were treated with oral sulodexide 50 mg/day for 6 months, while receiving concomitant medication as required. Two hundred thirty-seven patients (54% males and 46% females, mean age 55 years, mean diabetes duration 11 years) were evaluated; 89% had type 2 and 11% type 1 diabetes mellitus, 67% microalbuminuria and 33% macroalbuminuria. RESULTS: AER was significantly and progressively reduced during sulodexide treatment (p<0.0001): geometric mean after 3 and 6 months was 63.7% (95% confidence interval [95% CI], 59.3%-68.4%) and 42.7% (95% CI, 37.8%-48.2%) of baseline, respectively. The reduction was similar in type 1 and type 2 diabetes and was slightly greater in macroalbuminuric than in microalbuminuric patients. Blood pressure was slightly lowered, while fasting glucose and glycosylated hemoglobin were moderately reduced. Adverse effects were observed in 5.5% of patients, including gastrointestinal in 3.8%. CONCLUSIONS: Sulodexide therapy was shown to reduce AER in patients with DN.

[Evaluation of the iron bioavailability from meals prepared with lentil (Lens esculenta) or with white kidney bean seeds (Phaseolus vulgaris) in anemic rats]. / Evaluation de la biodisponibilite du fer fourni par des repas a base des lentilles (Lens esculenta) ou des haricots (Phaseolus vulgaris) chez le rat anemique.

The aim of our study was to evaluate the iron bioavailability from lentil seeds and white kidney bean seeds. The iron bioavailability from diets was measured in rat by the depletion-repletion hemoglobin method and the reserve of iron stored in the liver. Our results showed that the iron bioavailability from meal based on cooked lentil seeds was significantly low (3.9 +/- 0.9%) as compared to the reference group fed with ferrous sulfate (20.4 +/- 4.9%) (p < 0.01) or to the group fed with cooked white kidney bean seeds (14.3 +/- 2.4%) (p < 0.01). Moreover, the reserve of iron stored in the liver was significantly low in rats fed with cooked lentil seeds (80.4 microg) compared to the reference group or to the group fed with cooked white kidney bean seeds (99 microg in the two groups, p < 0.01).