In conclusion, the present findings - together with the recent demonstration that sulodexide prevented any increase in αSMA and decrease in cytokeratin in the peritoneal membrane of a rat model of peritoneal dialysis [21] - support the conviction that sulodexide could protect against renal fibrosis sustained by EMT, thereby preventing the progression of chronic kidney disease (and DN in particular) to ESRD. This evidence concerns the gene ACTA1 and renal fibrosis.