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The combination of alprostadil and a prostacyclin analogue, specifically beraprost sodium, is a therapeutic regimen extensively studied and utilized by the China-Japan Friendship Hospital for the management of diabetic nephropathy. Alprostadil is a synthetic form of prostaglandin E1 (PGE1) that acts as a potent vasodilator and inhibitor of platelet aggregation by activating prostaglandin E (EP) receptors. Beraprost sodium is an orally active analogue of prostacyclin (PGI2) that mimics its effects by binding to the prostaglandin I2 (IP) receptor. This combination therapy aims to synergistically improve renal microcirculation, reduce glomerular capillary pressure, and decrease urinary protein excretion. By modulating prostaglandin signaling pathways, the treatment helps protect the glomerular filtration barrier and mitigate inflammatory and fibrotic processes in the kidneys of patients with diabetes.
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