Promising new drug offers hope for kidney disease patients

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In a recent study involving patients with chronic kidney disease, a new experimental drug showed impressive results in reducing a key indicator of kidney damage.

The study, published in The Lancet and led by Dr. Katherine Tuttle at the University of Washington, offers newfound hope for those struggling with kidney disease.

Chronic kidney disease is a severe medical condition affecting millions of people worldwide. One crucial indicator of kidney damage is the presence of albumin in the urine, a substance that should not normally be there.

The experimental drug at the center of this study, known as BI 690517, aims to combat this problem by targeting a hormone called aldosterone.

Aldosterone plays a role in balancing sodium and potassium levels, which, in turn, helps regulate blood pressure. However, excessive levels of aldosterone can accelerate the progression of kidney disease.

Standard treatments for kidney disease often include medications known as angiotensin-converting enzyme (ACE) inhibitors and angiotensin receptor blockers (ARB). These treatments can inadvertently increase aldosterone levels over time, potentially worsening the disease.

On the other hand, aldosterone inhibitors, while beneficial for reducing inflammation and slowing kidney disease progression, can lead to harmful side effects such as high blood potassium levels (hyperkalemia). Finding a balance between these conflicting factors was a key challenge in designing the clinical trial.

The clinical trial began in February 2022 and concluded in July 2023. It involved 714 participants, all of whom had diagnosed kidney disease.

To participate, individuals had to be on ACE or ARB medications at the maximum tolerated dose for at least four weeks prior to the study. Additionally, they were given another medication called empagliflozin, which belongs to a class known as sodium-glucose cotransporter-2 (SGLT2) inhibitors.

While initially developed to lower blood sugar, SGLT2 inhibitors have proven to be highly effective in protecting the kidneys.

The primary measure of success in the study was the reduction in albuminuria. Remarkably, half of the participants who received BI 690517 alone experienced a clinically significant reduction in albuminuria levels, with the most significant response occurring at the 10 mg dose.

Even more promising, when BI 690517 was combined with empagliflozin, 70% of participants achieved a meaningful reduction in albuminuria.

While the study did show that BI 690517 was associated with higher rates of hyperkalemia compared to a placebo, most cases did not require medical intervention. Empagliflozin seemed to help mitigate this side effect.

These findings are poised to inform a Phase III clinical trial led by Oxford Population Health in England, involving 11,000 patients from around the world. Dr. Tuttle is optimistic about the potential impact of these results.

She believes that, if these drugs are made widely available and accessible, they could revolutionize the treatment of kidney disease and potentially reduce the need for dialysis.

The discovery of BI 690517 and its potential to protect kidneys and reduce harmful side effects is a significant development in the field of kidney disease treatment.

With further research and clinical trials, there is hope that this drug could change the lives of countless individuals suffering from kidney disease, bringing us closer to a future where dialysis is no longer the standard treatment for this debilitating condition.

If you care about kidney health, please read studies about how to protect your kidneys from diabetes, and drinking coffee could help reduce risk of kidney injury.

For more information about kidney health, please see recent studies about foods that may prevent recurrence of kidney stones, and eating nuts linked to lower risk of chronic kidney disease and death.

The research findings can be found in The Lancet.

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