Prostaglandin E1 for preventing the progression of diabetic kidney disease

Continuous albuminuria (protein in the urine) is the major characteristic of diabetic kidney disease (DKD), which is regarded primary cause of death and poor health in patients with diabetes mellitus, leading to end-stage-kidney disease. While blood pressure medication (such as angiotensin-converting enzyme inhibitors (ACEi), calcium channel blockers and angiotensin-receptor blockers (ARB)) has been used/recommended for reducing albuminuria and preventing the progression of DKD, the incidence of DKD is still increasing among developed and developing countries. Prostaglandin E1 (PGE1) is a vasodilator agent which is thought to contribute to releasing intraglomerular pressure, increasing kidney blood circulation and reducing albuminuria. This review identified six studies (271 participants) comparing PGE1 with or without ACEi/ARB versus ACEi/ARB, no treatment or Xueshuantong (a Chinese medicinal herb). The results suggest that PGE1 may have a positive effect on DKD by reducing urinary albumin excretion rate (UAER), microalbuminuria and proteinuria. No serious adverse events or allergic responses were reported. All studies were methodologically poor and there is no strong evidence for recommending PGE1 for preventing the progression of DKD as a routine therapeutic measure. More high-quality research is needed.