Diabetes is one of the leading causes of chronic kidney disease around the world. Millions of people living with diabetes eventually develop damage to the tiny blood vessels inside their kidneys.
As this damage becomes worse, the kidneys slowly lose their ability to remove waste and extra fluid from the body.
In severe cases, people may need dialysis or a kidney transplant to stay alive. Because of this, scientists are searching for better ways to protect the kidneys before permanent damage occurs.
A team of researchers at the University of Bristol has now made an important discovery that could lead to safer treatments for diabetic kidney disease.
Their findings, published in the journal JCI Insight, explain how a well-known medicine called spironolactone helps protect the kidneys.
The researchers believe this knowledge could eventually lead to new medicines that provide the same benefits with fewer side effects.
Spironolactone has been used for many years to treat high blood pressure, heart failure, and some hormone-related conditions.
Doctors have also known that it can reduce the amount of protein leaking into the urine, which is an early sign that the kidneys are being damaged. However, the medicine is not suitable for everyone because it can increase potassium levels in the blood, which may become dangerous if not carefully monitored.
In the new study, the scientists wanted to understand exactly how spironolactone protects the kidneys. They focused on a very thin, slippery coating called the glycocalyx. This gel-like layer covers the inside of tiny blood vessels and acts like a protective shield. It helps control what passes through blood vessel walls and plays an important role in keeping the kidneys working properly.
Using kidney biopsy samples, the researchers developed a new method to measure the thickness of this protective layer. They found that diabetes causes significant damage to the glycocalyx, making it less able to protect the kidneys. However, spironolactone helped preserve this layer and reduced the damage caused by diabetes.
The team also discovered why this protection happens. They found that spironolactone slows the activity of enzymes called matrix metalloproteases. These enzymes normally break down the glycocalyx when they become overactive. By reducing their activity, the medicine allows the protective layer to remain stronger for longer, helping the kidneys continue to function normally.
This discovery is exciting because it points scientists towards new treatment strategies. Instead of relying only on spironolactone, researchers may be able to develop new drugs that block these harmful enzymes without causing high potassium levels. Such medicines could make kidney protection safer for many more people living with diabetes.
Although more research and clinical trials are still needed, the findings represent an important step forward. They improve our understanding of diabetic kidney disease and may help prevent serious complications in the future. Protecting kidney function could reduce the number of people who eventually require dialysis or kidney transplantation.
People with diabetes can also lower their risk of kidney disease by keeping their blood sugar and blood pressure under good control, eating a healthy diet, staying physically active, avoiding smoking, taking prescribed medicines, and having regular kidney health checks.
While this new research is not yet a cure, it offers fresh hope that future treatments will better protect the kidneys and improve the lives of millions of people living with diabetes.
If you care about diabetes, please read studies about high vitamin D level linked to lower dementia risk in diabetes, and this eating habit could help reduce risk of type 2 diabetes.
For more health information, please see recent studies about unhealthy plant-based diets linked to metabolic syndrome, and results showing Paleo diet plus exercise could boost heart health in people with diabetes
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