Abstract: Objective To evaluate the clinical efficacy and safety of sequential treatment with alprostadil and beraprost sodium
for chronic renal failure caused by chronic glomerulonephritis. Methods Sixty-three patients with chronic renal failure due to
chronic glomerulonephritis, after receiving a 2-week-long conventional treatment, were randomly divided into alprostadil
group (n=20, with alprostadil injection at 10 μg/d for 2 weeks), sequential treatment group (n=21, with alprostadil injection at
10 μg/d for 2 weeks and oral beraprost sodium at 20 μg three times a day for 12 weeks), and strengthened sequential treatment
group (n=22, with alprostadil injection at 20 μg/d for 2 weeks and a double dose of oral beraprost sodium for 12 weeks).
Urinary albumin excretion rate (UAER), cystatin C (Cys C), blood urea nitrogen, creatinine, fibrinogen, D-dimer, prothrombin
time (PT), and platelets were tested before and after the treatment, and the changes in urinary albumin discharge rate, serum
creatinine, and glomerular filtration rate were determined. Results The patients in strengthened sequential treatment group
showed a significantly decreased change rate of urinary albumin discharge rate (P<0.01) than those in the other two groups. In
the two sequential treatment groups, especially the strengthened treatment group, the change rate of glomerular filtration rate
increased significantly compared with that in alprostadil group (P<0.01). Strengthened sequential treatment resulted also in
significantly decreased increment of serum creatinine compared that in the other 2 groups (P<0.01). After 14 weeks of
treatment, fibrinogen and D-dimer were decreased in all the 3 groups (P<0.05) to a comparable level between the 3 groups (P>
0.05), and prothrombin time (PT) or platelet showed no significant changes (P>0.05). Conclusion Sequential treatment with
alprostadil and beraprost sodium can improve the glomerular filtration rate and decrease urine albumin excretion rate, serum
creatinine increase rate, and lower blood fibrinogen and D-dimer levels, thus delaying the progression of chronic renal failure
caused by chronic glomerulonephritis. This therapy shows a dose-related effect with good clinical safety.