Clinical Efficacy of Alprostadil Combined with α-lipoic Acid in the Treatment of Elderly Patients with Diabetic Nephropathy.

Objective: To evaluate the effect and toxicity of alprostadil combined with thioctic acid injection in the treatment of patients with diabetic nephropathy (DN).

Methods: Sixty two patients with DN were included in this study and randomly divided into control group (n=32) and experiment group (n=30). Patients in the control group were given alprostadil 20ug+NS 100ml ivgtt, qd and patients in the experiment group were given alprostadil 20ug+NS 100ml ivgtt combined with thioctic acid injection of 0.45g+100ml ivgtt, qd for 14 days. After treatment, the renal function and serum level of CRP, IL-6 and TNF-α were compared between the two groups.

Results: After two weeks of treatment, the serum level of CysC and UAER significant decreased for both control and experiment group with statistical difference of p<0.05. After treatment, the serum level of CysC were 1.40 ±0.46 mg/L and 1.02±0.33 for control and experiment group respectively (p<0.05). The post-treatment UAER in experiment group was significantly lower than those of control group with statistical difference (81.02±0.33 vs112.45±20.32, p<0.05) ug/min. The serum level of CRP, IL-6 and TNF-α were significantly decreased after treatment for both control and experiment group (p<0.05). And the post-treatment serum CRP, IL-6 and TNF-α in experiment group were significantly lower than those of control group with statistical difference (p<0.05). No significant side effects were found for the two groupsin the course of treatment.

Conclusion: Alprostadil combined with α-lipoic acid may improve renal function in patients with diabetic nephropathy by decreasing the levels of serum inflammatory factors.