American journal of translational research · 2026
Effect of alprostadil combined with sulodexide on elderly chronic kidney disease patients and the independent risk factors affecting curative results.
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Yu Zhijie, Li Haiyan, Zhao Wei, Hou Liwei, Zan Shuangjiang
Аннотация
OBJECTIVES: Chronic kidney disease (CKD) is a global public health concern with high prevalence in the elderly. The study was designed to investigate curative efficacy of alprostadil in conjunction with sulodexide on elderly CKD patients and identify risk factors affecting treatment outcomes.
METHODS: This retrospective study enrolled 257 elderly CKD patients treated in our hospital from September 2020 to September 2024. Patients were divided into the alprostadil group (n = 122) and the alprostadil + sulodexide group (n = 135) based on treatment regimen. Serum creatinine (Scr), blood urea nitrogen (BUN), estimated glomerular filtration rate (eGFR), urinary albumin-to-creatinine ratio (UACR), and 24-hour urinary protein (24 h-UTP) were measured before and after 4 weeks of treatment. Therapeutic efficacy and adverse events were evaluated.
RESULTS: After treatment, the combination group showed significantly lower Scr (P = 0.001), higher eGFR (P = 0.007), and reduced UACR (P < 0.001) and 24 h-UTP (P < 0.001) compared to the alprostadil group. The total effective rate was significantly higher in the combination group (P = 0.009). Multivariate analysis identified age, diabetes, baseline Scr, and baseline UACR as independent risk factors for poor efficacy, while combination therapy was a protective factor. Receiver operating characteristic (ROC) analysis showed that Scr [area under the curve (AUC) = 0.712] and UACR (AUC = 0.722) had moderate predictive value for treatment efficacy.
CONCLUSION: Alprostadil combined with sulodexide significantly improves renal function and clinical efficacy in elderly patients with CKD, and baseline Scr and UACR serve as useful predictors of treatment response.
METHODS: This retrospective study enrolled 257 elderly CKD patients treated in our hospital from September 2020 to September 2024. Patients were divided into the alprostadil group (n = 122) and the alprostadil + sulodexide group (n = 135) based on treatment regimen. Serum creatinine (Scr), blood urea nitrogen (BUN), estimated glomerular filtration rate (eGFR), urinary albumin-to-creatinine ratio (UACR), and 24-hour urinary protein (24 h-UTP) were measured before and after 4 weeks of treatment. Therapeutic efficacy and adverse events were evaluated.
RESULTS: After treatment, the combination group showed significantly lower Scr (P = 0.001), higher eGFR (P = 0.007), and reduced UACR (P < 0.001) and 24 h-UTP (P < 0.001) compared to the alprostadil group. The total effective rate was significantly higher in the combination group (P = 0.009). Multivariate analysis identified age, diabetes, baseline Scr, and baseline UACR as independent risk factors for poor efficacy, while combination therapy was a protective factor. Receiver operating characteristic (ROC) analysis showed that Scr [area under the curve (AUC) = 0.712] and UACR (AUC = 0.722) had moderate predictive value for treatment efficacy.
CONCLUSION: Alprostadil combined with sulodexide significantly improves renal function and clinical efficacy in elderly patients with CKD, and baseline Scr and UACR serve as useful predictors of treatment response.