[Sulodexid and nephrotic syndrome in patients with diabetic nephropathy].

Diabetic nephropathy (DN) is the most serious, life limited complication of both types of diabetes mellitus. Therefore the early identification and intensive treatment of DN is very important. DN involves the thickening of glomerular basement membrane (GBM) and the depletion of glycosaminoglycan (GAG) in the GBM with resultant diminution in the physiological electrostatic charge barrier. Additional mechanism in pathophysiology of DN is mesangial expansion. Sulodexide is glycosaminoglycan mixture of heparansulfate and dermatan sulfate. We present a 71-year old patient with severe nephrotic syndrome, probably caused by DN. AS patient refused renal biopsy, exact diagnosis of DN could not be confirmed. Since 2000 our patient was treated with sulodexide. More pronounced decrease of proteinuria was proved 1.5 year after the begin of this treatment (from 10.37 g/d to 4.8 g/d) and after 3 years was proteinuria negative.