Effects of alprostadil combined with levocarnitine on renal function and inf1ammatory factors in patients with ESDN

Abstract

Objective To explore the effects of alprostadil combined with levocarnitine on renal function and serum levels of toll⁃like receptor⁃4 (TLR⁃4), interleukin⁃18 (IL⁃18) and tumor necrosis factor⁃α (TNF⁃α) in patients with end ⁃ stage diabetic nephropathy (ESDN). Methods 88 cases of patients with ESDN admitted between January 2015 and January 2018 were divided into observation group (n=44) and control group (n=44) Alprostadil was applied to both groups, and the observation group was combined with levocarnitine. renal function [serum creatinine (SCr), urea nitrogen (BUN), glomerular filtration rate (eGFR)], inflammatory factors (TLR⁃4, IL⁃18, TNF-α) and blood biochemical indicators [hemoglobin(Hb), serum albumin(ALB), cholesterol(TC)] were evaluated before treatment and after 4 weeks of treatment. The incidence rate of dialysis adverse reactions was recorded in the 2 groups. After 4 weeks of treatment, the levels of SCr and BUN in the 2 groups were lower than those before treatment (P<0.05), and the decrease in observation group was greater than that in control group (P<0.05). There was no significant difference in the eGFR within⁃groups before and after treatment and between groups(P>0.05). After 4 weeks of treatment, the levels of TLR⁃4, IL⁃18 and TNF⁃α in the 2 groups were lower than those before treatment (P<0.05), and the decrease in observation group was greater than that in control group (P<0.05). After 4 weeks of treatment, the levels of Hb and ALB in the 2 groups were higher than those before treatment (P<0.05) while the TC level in the 2 groups was lower than that before treatment (P<0.05), and the changes in observation group were greater than those in control group ( P<0.05 ). The incidence rate of adverse reactions in observation group was lower than in control group (P<0.05 ). Conclusions Alprostadil combined with levocarnitine is beneficial to reduce the levels of inflammatory factors, protect patients' renal function, Alprostadil combined with levocarnitine is beneficial to reduce the levels of inflammatory factors, protect patients' renal function, and reduce the risk of adverse reactions.