New medication may improve kidney function in individuals with type 2 diabetes

Kidney failure is one of the most common complications of type 2 diabetes, but a new study has shown that individuals with the disease may be able to preserve and potentially even repair damage to their kidneys with the help of a new anti-inflammatory drug.

While previous investigations have shown that certain anti-inflammatory medicines may slow the progression of renal disease in diabetics, no other drug has been shown to reverse the damage caused to the organ and restore kidney function.

The findings are important because kidney disease is so common among individuals with type 2 diabetes. Diabetes is the leading cause of end stage renal disease, accounting for more than half of all new cases. Once a patient has progressed to this stage of the disease they require constant dialysis or a kidney transplant.

"In diabetes, kidney function tends to deteriorate over time," said Dr. Robert Toto, MD, the UT Southwest Medical Center researcher who led the investigation. "No prior studies of this duration have shown what appears to be an increase in kidney function by any therapy, which makes this a very exciting development."

Toto and his team reported in the New England Journal of Medicine that individuals with type 2 diabetes may be able to completely avoid kidney disease with the help of a new anti-inflammatory drug known as bardoxolone methyl.

For the study, the team divided a group of 227 individuals with type 2 diabetes and chronic kidney disease into four separate groups. Three sections received various doses of the medication while the fourth was given a placebo.

The researchers found that after 52 weeks of treatment, all participants in the medication groups made significant improvements in the function of their kidneys, as measured by glomerular filtration rates.

Furthermore, kidney testing conducted four weeks after participants were taken off the medication indicated that renal function was still higher in the test subjects than before the study began. The researchers said that this is important because it implies that bardoxolone methyl may have significant long-term benefits.

"The results of this study show promise for bardoxolone methyl in the treatment of kidney disease in those with type 2 diabetes," said Dr. Toto. "If it's confirmed to be effective and safe in the long term, this drug could potentially have a major positive impact on kidney disease and become part of the standard of care."

For further investigation, Toto said that he and his team are planning a larger, more extended study to determine the long-term safety and effectiveness of the drug. While the results of the present investigation are promising, he said it is important to proceed cautiously to make sure that bardoxolone methyl is an appropriate treatment for individuals with type 2 diabetes and kidney disease.

Given the prevalence of renal disease among individuals with type 2 diabetes, the National Institute of Diabetes and Digestive and Kidney Diseases recommends that everyone with impaired metabolic function seek regular kidney testing.