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Pirfenidone improves kidney function in diabetic patients

Kathleen Blanchard's picture
kidney disease drug trial

Positive results of a new drug clinical drug trial could mean new hope for diabetics with kidney disease. According to a report from researchers at the University of California, San Diego School of Medicine, the National Institutes of Health (NIH) and the Mayo Clinic, the drug pirfenidone was able to stop kidney damage and even improve kidney disease in diabetic patients given the anti-inflammatory drug that also reduces kidney scarring.

Kidney disease drug shows 'dramatic' results

The researchers say the results of the trial were dramatic because the drug was able to improve kidney function in diabetic patients whose usual option is dialysis, antihypertensive drugs and glucose control.

The anti-fibrotic properties of pirfenidone are unique in that it blocks the action of the protein TGF-β that is overexpressed in diabetic kidneys in response to blood sugar levels and hypertension.

Kumar Sharma, MD, FAHA, professor of medicine in the UCSD division of nephrology and director of the Center for Renal Translational Medicine, said, “To date, therapies for diabetic nephropathy have been limited to drugs that improve blood pressure or control blood sugar levels.” Pirfenidone shuts down the process that leads to kidney scarring in diabetic patients.

Low dose pirfenidone improved diabetic nephropathy

For the study, researchers tested low and high doses of pirfenidone among three groups of patients with diabetic nephropathy.

The trial included 77 patients who were followed at Thomas Jefferson Hospital in Philadelphia, the Mayo Clinic in Rochester and the National Institutes of Health (NIH). The participants received placebo, 2400mg of pirfenidone or 1200mg.

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Kidney function was measured using eGFR, estimated glomerular filtration rate, in all three groups. The drug substantially improved kidney function in the group receiving the lower dose of pirfenidone. The researchers suspect higher doses may not be tolerated by diabetic patients.

The drug may help other types of kidney disease related to fibrosis, or scarring, the researchers suggest. Pirfenidone was shown to help patients with focal segmental glomerulosclerosis, another type of `chronic kidney disease.

Mouse studies showed the drug could dramatically improved renal function, after just four weeks, in findings published two years ago in the Journal of the American Society of Nephrology (JASN).

Larger clinical trials are planned to see which patients with kidney disease would benefit from the drug. The results of the current study are promising for patients living with kidney disease who could gain years of life and possibly postpone the need for dialysis.

JASN: doi: 10.1681/ASN.201010104
"Pirfenidone for Diabetic Nephropathy"
Kumar Sharma et al

Source: UC San Diego News Release

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