Kidney Disease information : Nephrology

Why some kidney disease patients can't repair blood vessels

In some kidney diseases, patients have high blood levels of a protein that blocks blood vessel repair, according to a study appearing in an upcoming issue of the Journal of the American Society Nephrology (JASN). Inhibiting the protein may reduce patients' risk of developing kidney failure.

Patients with an autoimmune kidney disorder called anti-neutrophil cytoplasmic antibody (ANCA)-associated vasculitis produce antibodies that damage blood vessels in the kidneys. Researchers have wondered what factors play a role in determining whether patients' bodies can repair this damage.

To investigate, Sandrine Le Roux, PhD, Fadi Fakhouri, MD, PhD (Institute of Transplantation Urology Nephrology, in Nantes, France), and their colleagues examined the blood of 81 patients with ANCA-associated vasculitis, 21 patients with other types of kidney disease, and 18 healthy individuals.

The investigators found that compared with others in the study, patients with ANCA-associated vasculitis harbor elevated blood levels of the molecule Flt1, which hinders the repair of blood vessels. As a result, their bodies may not be able to fix damaged blood vessels, setting them on a path of continued disease progression.

"Our data suggest that in some kidney diseases, not only are blood vessels damaged, but their repair is also impaired by an increase of Flt1 in the blood," said Dr. Fakhouri. "Inhibiting Flt1 may help improve blood vessel repair in some kidney disease patients and thus reduce their risk of progression to kidney failure," he added.

More information: The article, entitled "Elevated Soluble Flt1 Inhibits Endothelial Repair in PR3-ANCA-Associated Vasculitis," will appear online on Thursday, October 27, 2011

Vitamin B derivative helps diabetics with mild kidney disease

A vitamin B6 derivative may help slow or prevent the progression of mild kidney disease in patients with diabetes, according to a study appearing in an upcoming issue of the Journal of the American Society Nephrology(JASN). The drug may benefit increasing numbers of patients as the prevalence of diabetes rises.

Approximately 40% of all patients who need dialysis or a kidney transplant can blame diabetes for their kidney problems. Because the number of patients withtype 2 diabetes is expected to double by 2030, the prevalence of kidney failure is sure to increase. New therapies that can delay the progression of diabetic kidney disease may help prevent kidney failure and save lives. Researchers have wondered whether the drug Pyridorin, a derivative of vitamin B6, may be such a candidate. Pyridorin targets several cellular processes that may be relevant to the progression of diabetic kidney disease.

Edmund Lewis, MD (Rush University Medical Center) and his colleagues within the Collaborative Study Group (a large clinical trial group comprised of various kidney care centers) tested the potential of Pyridorin (generic name pyridoxamine dihydrochloride) for treating patients with diabetic kidney disease.

For one year during the double-blind, randomized, placebo-controlled trial, 317 patients received placebo twice a day, Pyridorin at a dose of 150 mg twice a day, or Pyridorin at a dose of 300 mg twice a day.

Overall, the drug did not provide any benefit over placebo for slowing or preventing the progression of diabetic kidney disease; however, Pyridorin did help patients with only mild forms of the disease.

"It appears the drug may be beneficial in a sub-group of patients with only mild kidney disease but does not appear to be beneficial for patients with more advanced kidney disease," said Dr. Lewis. "The results warrant further trials in patients with mild diabetic kidney disease," he added.

More information: The article, entitled "A Randomized Trial of Pyridorin in Type 2 Diabetes,