OBJECTIVETo investigate the therapeutic effect of prostaglandin E1 (PGEl) on diabetic nephropathy (DN) after a one-year treatment.

METHODSAccording to Mogensen DN diagnostic criteria, the patients were divided into DN stages III, IV and V groups. Patients in stage IV nephropathy were subdivided into three groups according to the proteinuria, namely early stage IV (protienuria less than 1.5 g/day), mid-stage IV (protienuria between 1.5 and 2.5 g/day) and late stage IV (protienuria above 2.5 g/day). The patients were randomly given PGEl, PGEl plus angiotensin-converting enzyme inhibitor (ACEI), ACEI mono-therapy or basal treatment (control group). Proteinuria and albuminuria were measured before and at 15 days and 1 year of the treatment.

RESULTSIn the patients in DN stages III and early stage IV, proteinuria and albuminuria decreased significantly after 15 days and 1 year of treatment with PGEl+ACEI and PGEl (P<0.01), and the decrements were greater than that in patients receiving ACEI only (P<0.01 or P<0.05). In the patients in mid- and late stage IV nephropathy, proteinuria and albuminuria decreased significantly in PGEl+ACEI group after 15 days and 1 year of treatment (P<0.01), showing greater decrement than in ACEI group (P<0.01 ). Proteinuria and albuminuria decreased significantly in PGEl group after 15 days of treatment (P<0.01), but remained higher than that in ACEI group at one year (P<0.05). In the patients with stage V nephropathy, significant proteinuria and albuminuria reduction occurred in PGEl+ACEI and PGEl groups at 15 days (P<0.01) with a greater decrement than that in ACEI group (P<0.01 or P<0.05). In PGEl+ACEI group, proteinuria and albuminuria showed no significant changes at one year but were lower than those in ACEI group (P<0.05). Proteinuria and albuminuria increased significantly in ACEI and PGEl group after the treatment but were comparable between the two groups (P<0.05).

CONCLUSIONSThe therapeutic effects are much better in patients with stage III nephropathy than in those in stage V. The combination of PGEl and ACEI produces stronger therapeutic effects than PGE1 or ACEI alone even at the one-year follow up.