A recent study from the University of Bristol offers new hope for people with diabetes, who are at a high risk of kidney complications.
The research suggests that spironolactone, a common blood pressure medication, could help slow the progression of diabetic kidney disease—a condition affecting around 40% of people with diabetes.
For many of the 4.8 million people in the UK with diabetes, kidney disease is a serious concern.
These individuals face a much higher chance of needing dialysis or a kidney transplant due to the damaging effects of high blood sugar on the kidneys over time. Because of this, finding treatments that can protect kidney health is crucial.
The study focused on how spironolactone might prevent kidney damage in people with diabetes. Spironolactone is already known to reduce protein loss in urine, which is a good sign for kidney health.
However, doctors are often hesitant to prescribe it for diabetic kidney disease due to its potential to increase potassium levels in the blood, which can be dangerous for some patients.
To understand how spironolactone protects the kidneys, the researchers looked at the effect of the drug on a special part of the kidney’s blood vessels called the glycocalyx.
This layer is like a protective gel on the surface of blood vessels, which helps to keep them healthy. In diabetic kidney disease, this layer often becomes damaged, which can lead to more severe kidney issues.
Using kidney tissue samples, the researchers developed a method to measure changes in the glycocalyx layer. They found that diabetes damages this layer, but spironolactone helps protect it.
The drug also reduces the activity of enzymes known as matrix metalloproteases, which, if overactive, can break down the glycocalyx layer further. By lowering these enzymes’ activity, spironolactone helps keep the protective glycocalyx intact and reduces kidney damage.
The results are promising, but spironolactone’s side effects mean that it’s not the perfect solution for everyone.
Because of this, researchers plan to explore other drugs that could offer similar protection without the risk of raising potassium levels. Their goal is to find safer treatments that provide the same benefits as spironolactone for people with kidney disease.
For people with diabetes, protecting kidney health is essential. In addition to medication, there are several lifestyle steps that can help:
- Control blood sugar: Keeping blood sugar within a healthy range helps prevent long-term kidney damage.
- Manage blood pressure: High blood pressure strains the kidneys, so keeping it at or below 130/80 mm Hg is crucial.
- Eat a balanced diet: A diet low in salt and saturated fats, and rich in fruits, vegetables, whole grains, and lean proteins, supports kidney health.
- Exercise regularly: Getting at least 30 minutes of moderate exercise most days can improve health and reduce the risk of kidney disease.
- Quit smoking: Smoking damages blood vessels, including those in the kidneys, and increases the risk of kidney disease.
- Follow medication plans: Taking prescribed diabetes and blood pressure medications is key to protecting kidney function.
- Regular kidney function tests: Testing kidney function can help detect any early signs of damage, allowing for timely treatment.
This research by Dr. Matthew Butler and his team, published in JCI Insight, marks a step forward in understanding how to treat diabetic kidney disease.
While spironolactone shows promise, continued studies will help find the best approaches to keep kidneys healthy for those with diabetes.
For those interested in learning more, studies on blood pressure control and the role of diet in kidney health provide useful insights into managing both diabetes and kidney health effectively.
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