In a study from the University of Bristol, scientists found a new method to reduce the progression of diabetic kidney disease, affecting 40% of people with diabetes.
The findings could help the 4.8 million people in the UK with diabetes who are four times more likely to need either dialysis or a kidney transplant.
Recent clinical trials show a commonly used blood pressure medicine, known as spironolactone, is an effective treatment by reducing protein leak into the urine.
However, despite its positive effect, the drug can have adverse side effects, causing problems including high blood potassium levels (hyperkalaemia) in patients, making clinicians reluctant to use it.
In the study, the team to understand how spironolactone prevents damage to the kidneys.
They found that the drug has a protective effect by helping preserve the gel-like glycocalyx layer on the surface of blood vessels within the kidney.
Using novel alternative therapeutics to slow down glycocalyx layer degradation in diabetes directly could now help them recreate the same effect but without adverse side effects.
The team used patient kidney biopsy specimens to develop a novel method to measure glycocalyx depth changes to confirm that diabetes damages the endothelial glycocalyx layer, and spironolactone prevents this damage.
Their results showed spironolactone reduces the activity of a group of enzymes, called matrix metalloproteases.
This can help to preserve the gel-like glycocalyx layer on the surface of the blood vessels in the kidney, preventing disease progression.
The team’s next steps will be to look at repurposing drugs that target matrix metalloproteases enzymes [MMPs] to see if they could be of benefit in patients with kidney disease and avoid the troublesome side effects associated with mineralocorticoid receptor blockers.
This work is an important step that will allow new treatments for diabetic kidney disease to be identified faster.
If you care about kidney health, please read studies about drug that prevents kidney failure in diabetes, and drinking coffee could help reduce risk of kidney injury.
For more information about health, please see recent studies that blueberries strongly benefit people with metabolic syndrome, and common painkillers may harm heart, kidneys and more.
The study was conducted by Dr. Matthew Butler et al and published in JCI Insight.
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