Lipo-prostaglandin E1 improves renal hypoxia evaluated by BOLD-MRI in patients with diabetic kidney disease


      • BOLD-MRI techniques are effective in monitoring and assessing renal hypoxia in diabetic kidney disease.
      • Lipo-PGE1 was shown to improve kidney medullay oxygenation in patients with DKD.
      • The possible renoprotective effects of lipo-PGE1 in acute renal ischemic injury and chronic progression to renal failure in DKD.



      To evaluate the effect of lipo-PGE1 on renal hypoxia in patients with DKD by BOLD-MRI.

      Materials and methods

      All patients were divided into DKD group and CKD-without-diabetes group. All patients received intravenous 10 μg lipo-PGE1 once daily for 14 days. BOLD-MRI was performed before and after lipo-PGE1 administration to acquire renal CR2* and MR2* values.


      Renal MR2* value in DKD group after lipo-PGE1 treatment were significantly decreased compared with the baseline. However, no significant differences in MR2* values were found in the CKD-without-diabetes group.


      Lipo-PGE1 was shown to improve kidney medullary oxygenation in patients with DKD.


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        • de Boer I.H.
        • Rue T.C.
        • Hall Y.N.
        • Heagerty P.J.
        • Weiss N.S.
        • Himmelfarb J.
        Temporal trends in the prevalence of diabetic kidney disease in the United States.
        JAMA. 2011; 305: 2532-2539
        • Wild S.
        • Roglic G.
        • Green A.
        • Sicree R.
        • King H.
        Global prevalence of diabetes: estimates for the year 2000 and projections for 2030.
        Diabetes Care. 2004; 27: 1047-1053
        • Vejakama P.
        • Thakkinstian A.
        • Lertrattananon D.
        • Ingsathit A.
        • Ngarmukos C.
        • Attia J.
        Reno-protective effects of renin-angiotensin system blockade in type 2 diabetic patients: a systematic review and network meta-analysis.
        Diabetologia. 2012; 55: 566-578
        • Fine L.G.
        • Norman J.T.
        Chronic hypoxia as a mechanism of progression of chronic kidney diseases: from hypothesis to novel therapeutics.
        Kidney Int. 2008; 74: 867-872
        • Rosenberger C.
        • Khamaisi M.
        • Abassi Z.
        • et al.
        Adaptation to hypoxia in the diabetic rat kidney.
        Kidney Int. 2008; 73: 34-42
        • Yin W.J.
        • Liu F.
        • Li X.M.
        • et al.
        Noninvasive evaluation of renal oxygenation in diabetic nephropathy by BOLD-MRI.
        Eur J Radiol. 2012; 81: 1426-1431
        • Rubin D.
        • Laposata M.
        Regulation of agonist-induced prostaglandin E1 versus prostaglandin E2 production. A mass analysis.
        J Biol Chem. 1991; 266: 23618-23623
        • Itoh Y.
        • Yasui T.
        • Kakizawa H.
        • et al.
        The therapeutic effect of lipo PGE1 on diabetic neuropathy-changes in endothelin and various angiopathic factors.
        Prostaglandins Other Lipid Mediat. 2001; 66: 221-234
        • Wang H.
        • Deng J.L.
        • Yue J.
        • Li J.
        • Hou Y.B.
        Prostaglandin E1 for preventing the progression of diabetic kidney disease.
        Cochrane Database Syst Rev. 2010; 5 (CD006872): 1-36
        • Sun D.
        • Liu C.X.
        • Ma Y.Y.
        • Zhang L.
        Protective effect of prostaglandin E1 on renal microvascular injury in rats of acute aristolochic acid nephropathy.
        Ren Fail. 2011; 33: 225-232
        • Tervaert T.W.
        • Mooyaart A.L.
        • Amann K.
        • et al.
        Pathologic classification of diabetic nephropathy.
        J Am Soc Nephrol. 2010; 21: 556-563
        • Molitch M.E.
        • Adler A.I.
        • Flyvbjerg A.
        • et al.
        Diabetic kidney disease: a clinical update from Kidney Disease: Improving Global Outcomes.
        Kidney Int. 2015; 87: 20-30
        • Fine L.G.
        • Orphanides C.
        • Norman J.T.
        Progressive renal disease: the chronic hypoxia hypothesis.
        Kidney Int Suppl. 1998; 65: S74-78
        • Nangaku M.
        Chronic hypoxia and tubulointerstitial injury: a final common pathway to end-stage renal failure.
        J Am Soc Nephrol. 2006; 17: 17-25
        • Singh D.K.
        • Winocour P.
        • Farrington K.
        Mechanisms of disease: the hypoxic tubular hypothesis of diabetic nephropathy.
        Nat Clin Pract Nephrol. 2008; 4: 216-226
        • Miyata T.
        • de Strihou C.
        Diabetic nephropathy: a disorder of oxygen metabolism?.
        Nat Rev Nephrol. 2010; 6: 83-95
        • Pruijm M.
        • Hofmann L.
        • Zanchi A.
        • et al.
        Blockade of the renin-angiotensin system and renal tissue oxygenation as measured with BOLD-MRI in patients with type 2 diabetes.
        Diabetes Res Clin Pract. 2013; 99: 136-144
        • Inoue T.
        • Kozawa E.
        • Okada H.
        • et al.
        Noninvasive evaluation of kidney hypoxia and fibrosis using magnetic resonance imaging.
        J Am Soc Nephrol. 2011; 22: 1429-1434
        • Zhang J.L.
        • Morrell G.
        • Rusinek H.
        • et al.
        New magnetic resonance imaging methods in nephrology.
        Kidney Int. 2014; 85: 768-778
        • Baines A.
        • Ho P.
        Glucose stimulates O2 consumption, NOS, and Na/H exchange in diabetic rat proximal tubules.
        Am J Physiol Renal Physiol. 2002; 283: F286-293
        • Ries M.
        • Basseau F.
        • Tyndal B.
        • et al.
        Renal diffusion and BOLD MRI in experimental diabetic nephropathy. Blood oxygen level-dependent.
        J Magn Reson Imaging. 2003; 17: 104-113
        • Palm F.
        Intrarenal oxygen in diabetes and a possible link to diabetic nephropathy.
        Clin Exp Pharmacol Physiol. 2006; 33: 997-1001
        • Magri C.J.
        • Fava S.
        The role of tubular injury in diabetic nephropathy.
        Eur J Intern Med. 2009; 20: 551-555
        • Luo C.
        • Li T.
        • Zhang C.
        • et al.
        Therapeutic effect of alprostadil in diabetic nephropathy: possible roles of angiopoietin-2 and IL-18.
        Cell Physiol Biochem. 2014; 34: 916-928
        • Okada S.
        • Ichiki K.
        • Tanokuchi S.
        • Ishii K.
        • Hamada H.
        • Ota Z.
        Effect of prostaglandin E1 on the renin-aldosterone system in patients with diabetic nephropathy.
        J Int Med Res. 1993; 21: 126-132
        • Haider D.G.
        • Bucek R.A.
        • Giurgea A.G.
        • et al.
        PGE1 analog alprostadil induces VEGF and eNOS expression in endothelial cells.
        Am J Physiol Heart Circ Physiol. 2005; 289: H2066-2072
        • Allison S.J.
        Acute kidney injury: mechanism of AKI sensitivity in diabetic nephropathy.
        Nat Rev Nephrol. 2014; 10: 484
        • Peng J.
        • Li X.
        • Zhang D.
        • et al.
        Hyperglycemia, p53, and mitochondrial pathway of apoptosis are involved in the susceptibility of diabetic models to ischemic acute kidney injury.
        Kidney Int. 2015; 87: 137-150
        • Kelly K.J.
        • Dominguez J.H.
        Rapid progression of diabetic nephropathy is linked to inflammation and episodes of acute renal failure.
        Am J Nephrol. 2010; 32: 469-475
        • Vallon V.
        Do tubular changes in the diabetic kidney affect the susceptibility to acute kidney injury?.
        Nephron Clin Pract. 2014; 127: 133-138
        • Liu W.J.
        • Zhang B.C.
        • Guo R.
        • Wei Y.D.
        • Li W.M.
        • Xu Y.W.
        Renoprotective effect of alprostadil in combination with statins in patients with mild to moderate renal failure undergoing coronary angiography.
        Chin Med J (Engl). 2013; 126: 3475-3480