Two Drugs in Combination May Keep Diabetics’ Kidneys Working
One of the devastating effects of long term diabetes is severe kidney damage and there has up until now been little to prevent this complication. Hope may be on the horizon with a new study that used two existing drugs to prevent kidney damage in the diabetic patient.
By using a combination of losartan (Cozaar) and aliskiren (Tekturna) researchers have shown that it may be possible to block kidney damage in diabetic patients.
The report, which appears in June 5 issue of the New England Journal of Medicine, took about 600 patients with type 2 diabetes(adult onset diabetes). A 6 month study was performed. Half received losartan and aliskiren, and half the patients received losartan with a placebo. The two drug treatment reduced the amount of urinary protein 50 percent or more in about 25% of patients. Only12.5 percent of patients who received the placebo had the protein in their urine reduced.
Dr. Matthew Weir MD, director of of nephrology at the University of Maryland School of Medicine stated “Kidney failure is a major problem in diabetes, and reducing the rate of failure would be a major achievement.”
U.S. Food and Drug Administration currently does not officially consider reduction of protein in urine to be an indicator of success in saving kidney function. Scientists in the field however feel that the results are encouraging and are proceeding to do further studies and some are even using the information to try to treat patients more effectively.
Dr. Matthew Weir says”The ultimate plan now would be to do a full kidney protection trial over, say, three years to show that this is a better strategy to prevent kidney failure,” he said.
Weir himself is not waiting for such a trial to use the two-drug therapy. “I have been doing it for a while, because I have been aware of this study for a while,” he said.
Dr. Robert Zimmerman, director of the Cleveland Clinic endocrinology department agrees with Dr. Matthew Weir. “Certainly, this is pointing in the direction you want to see,” he said.
Diabetes is probably the leading cause of kidney failure that leads to dialysis, Zimmerman added. “About 50 percent of dialysis is probably due to diabetes.”
But he agreed with Weir that more work is necessary. “We clearly need to have more long-term data,” Zimmerman said. “That would be the next stage, to see whether this truly proves to be a treatment that ought to be used more frequently.”
ref: http://content.nejm.org/cgi/content/short/358/23/2433
