Comparison of Losartan Potassium and Alprostadil in the Treatment of Diabetes and Nephropathy
Studies have shown that glomerular hemodynamics in diabetes mellitus (DM) is related to abnormal prostaglandin metabolism, which represents the imbalance of thromboxane A2 and prostaglandin. The decrease of prostaglandin E2 synthesis in diabetic patients and the increase of the concentration of the physiological antagonist, TXA2, make the renal microcirculation disorder. And the increase of the permeability of glomerular filtration membrane and the content of proteinuria let diabetic nephropathy worsen. ARB drugs (Losartan potassium) are used to selectively dilate glomerular arteriole, reduce glomerular pressure and reduce proteinuria. It can also directly affect the permeability of glomerular, prevent glomerular sclerosis, reduce the damage of glomerular mesenchyme and prevent the progressive damage of glomerulus. It is widely used in clinical practice. Through dilating renal vessels, Alprostadil (PGE1) can improve renal tissue ischemia and hypoxia, inhibit the formation of platelet aggregation and immune complex, prevent the formation of thrombus in the glomerulus, and inhibit the role of inflammatory mediators, thus it can improve renal function and reduce proteinuria. Losartan potassium which is a kind of ARB drug can make the serum creatinine increase and make the azotemia be worse when renal dysfunction is not decompensated in diabetic nephropathy, but the alprostadil does not aggravate azemia, and it can reduce it to a certain extent. Therefore, alprostadil in the early treatment of diabetic nephropathy proteinuria, can improve renal function more reasonable and superior than ARB drugs.