Diabetic kidney disease trials vital

A third of diabetics in the US will develop serious kidney disease within 20 yrs of their diagnosis.

Paul Wild has been a reliable research volunteer at the University of Minnesota for 20 years, participating in two landmark studies that changed the standard of care for diabetes.

“Looking back, it was probably the best thing I ever did,” the 61-year-old dentist said.

Now Wild is among 480 patients being recruited for a $US24 million ($A25.97 million), three-and-a-half year test to see whether a medication that has been used routinely to prevent gout can delay the onset of potentially fatal kidney disease in patients with type 1 diabetes.

If the study succeeds, the medication, allopurinol, could be to diabetic kidney disease what baby aspirin is to heart attacks, said Dr Luiza Caramori, an endocrinologist helping to oversee the study at the university.

The drug could delay the need for dialysis and kidney transplants by eight to 10 years, she said.

Up to 30 per cent of diabetics in the US will develop serious kidney disease within 20 years of their diagnosis, making it the leading cause of kidney failure in that country. And because the waiting list for a kidney is so long, hundreds of patients die each year waiting for a transplant.

While the University of Minnesota study is limited to subjects with type 1 diabetes, Caramori said positive findings are likely also to benefit the far more common type 2 diabetics.

“It’s amazing that in the past 20 years we’ve basically made no progress in delaying kidney disease in patients with diabetes,” she said.

“It’s also disappointing and scary, because the rates of complications are quite high in these patients.”

Type 1 diabetes occurs when the immune system destroys the body’s ability to produce insulin.

It affects fewer than 1 in 10 diabetics. Type 2 often results from genetic predisposition, coupled with obesity and lifestyle factors, leading initially to resistance to the body’s own insulin.

Allopurinol suppresses the production of an enzyme, xanthine oxidase, a result of metabolic activity, which can lead to excess acid in the urine.

The drug is cheap and has been used in the US for nearly 50 years to prevent gout flare-ups.

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