Acute renal failure, new drug found

Acute renal failure, a new drug found.

Serious diseases causing kidneys to suddenly stop working could be treated with existing drugs, a new study shows.

In a study conducted on mice, scientists discovered that drugs, usually used to treat angina pectoris (pain in the chest, behind the breastbone, caused by insufficient oxygenation from the heart) – and high blood pressure, which prevent a large part of the long-term damage to the kidneys and cardiovascular system caused by angina. Experts hope the findings pave the way for better treatment of acute renal failure (ARF).

The condition is usually caused by other diseases that reduce the blood supply to the kidneys or by the toxicity of some drugs. ARI must be treated quickly to avoid death. Even if the kidneys recover, it can cause long-lasting damage to the kidneys and cardiovascular system. Of those who survive an episode of acute kidney failure, 30% remain with chronic kidney disease. The remaining 70%, who recover full renal function, have an almost 30 times greater risk of developing chronic renal failure.

A team from the University of Edinburgh found that patients with kidney failure had increased blood levels of endothelin , a protein that triggers inflammation and causes blood vessels to constrict. Endothelin levels remained elevated even after recovery of renal function. After finding the same increase in endothelin in mice with ARF, the experts treated the animals with drugs that block the endothelin system. The drugs, usually used to treat angina and high blood pressure, work by blocking the production of the protein or by turning off the endothelin receptors in the cells. The mice were monitored for a period of four weeks after the IRA. Those treated with the endothelin-blocking drugs had lower blood pressure, less inflammation, and reduced scarring in the kidney.

Their blood vessels were more relaxed and kidney function also improved, compared to untreated mice. The study is published in Science Translational Medicine . Dr Bean Dhaun, Senior Clinical Lecturer and Honorary Consultant Nephrologist at the University of Edinburgh’s Cardiovascular Science Centre, said: ‘ARF is a harmful condition, particularly in older people, and even with recovery it can have a long-term impact on a person’s health. Our study shows that blocking the endothelin system prevents long-term damage. Since these drugs are already available for use in humans, I hope we can move quickly to see if the same beneficial effects are manifested in our patients.”

“This promising research suggests that widely available medicines could help address the impact of acute kidney injury before it can cause damage and further complications. While more studies will be needed to show whether this treatment is safe and effective for patients, this early research is an encouraging first step.”

• Endothelin blockade prevents the long-term cardiovascular and renal sequelae of acute kidney injury in mice (science.org)