Efficacy of Heparinoid Supplementation on Mortality and Disease Progression in Adults with Diabetic Kidney Disease



diabetes mellitus, diabetic nephropathy, heparinoid, meta-analysis


*Visual Abstracts prepared by Dr. Carmen Carina Cabrera

Objectives. To evaluate the safety and efficacy of heparinoid supplementation on all-cause mortality and disease progression in diabetic kidney disease (DKD).

Methodology. Trials evaluating heparinoid supplementation in DKD were included. Two authors performed a literature search with eligible studies undergoing validity screen, data extraction, and statistical analysis. Results were calculated using the Mantel-Haenszel odds ratio for dichotomous variables and the inverse variance method for continuous variables, and pooled using a random or fixed effects model depending on heterogeneity

Results. Twelve trials were included in the analysis. Eight involved sulodexide while two each involved low molecular weight heparin and danaparoid. We found no statistically significant difference between the heparinoid and placebo groups for all-cause mortality (95% CI, HR 0.79 [0.41, 1.53], p=0.49), number of patients reaching therapeutic success (95% CI, OR 0.97 [0.71, 1.33], p=0.87), serum creatinine (95% CI, MD 2.55 umol/L [-0.54, 5.65], p=0.11), and creatinine clearance (95% CI, MD -8.55 mg/min [-18.28, 1.18], p=0.09). We also found no statistically significant difference in urinary albumin excretion rate (UAER) between Type 2 heparinoid-treated DKD patients compared to placebo (95% CI, log transformed MD 0.13 mg/24h [-0.42, 0.68], p=0.65); however, a statistically significant UAER reduction was seen in Type 1 heparinoid-treated DKD patients compared to placebo (95% CI, log-transformed MD -1.5 mg/24h [-2.79, -0.21], p=0.02). This subgroup analysis was performed due to initial heterogeneity (I^2=57%).

Conclusion. Heparinoid supplementation was not associated with statistically significant changes in Type 2 DM patients. However, it may be associated with a statistically significant UAER reduction of approximately 31.62 mg/24 h as compared to placebo in Type 1 DM patients. Due to sparse data on hard clinical outcomes, larger studies are recommended.


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Author Biographies

Marc Gregory Yu, Philippine General Hospital


Section of Endocrinology, Diabetes, and Metabolism

Department of Medicine

Louren Blanquisco, Philippine General Hospital


Section of Endocrinology, Diabetes, and Metabolism

Department of Medicine

Ma. Cecille Anonuevo-Cruz, Philippine General Hospital

Clinical Associate Professor

Section of Endocrinology, Diabetes, and Metabolism

Department of Medicine


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How to Cite

Yu, M. G., Blanquisco, L., & Anonuevo-Cruz, M. C. (2017). Efficacy of Heparinoid Supplementation on Mortality and Disease Progression in Adults with Diabetic Kidney Disease. Journal of the ASEAN Federation of Endocrine Societies, 32(1), 20. Retrieved from https://asean-endocrinejournal.org/index.php/JAFES/article/view/379



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