New research shows potential to treat kidney disease with common medicines

A team of researchers from the University of Edinburgh have found that commonly available medicines could be used to treat acute kidney injury (AKI), a condition which causes the kidneys to suddenly stop working.

The researchers, funded by the British Heart Foundation (BHF) and the Medical Research Council, hope their findings will lead to improved treatments for AKI after finding medicines used to treat angina and high blood pressure prevented the long-term damage to the kidney and cardiovascular system caused by the condition.

AKI, which is usually caused by other illnesses that reduce blood flow to the kidneys or by toxicity from some medicines, occurs in around 20% of all emergency hospital admissions in the UK.

The condition must be treated quickly to prevent death, however patients who survive an episode of AKI can still experience long-lasting damage to the kidneys and circulatory system, with 30% left with chronic kidney disease (CKD) and the remaining 70% at an almost 30-fold increased risk of developing CKD.

“Impaired kidney function that results from AKI can also increase a person’s chance of developing and dying from heart and circulatory diseases, so it’s vital we find ways to reduce this risk,” said Professor James Leiper, BHF associate medical director.

The study, which was published in the journal Science Translational Medicine, showed that AKI patients had increased blood levels of endothelin – a protein that triggers inflammation and causes blood vessels to constrict – with these levels remaining high long after kidney function had recovered.

After finding the same increase in endothelin in mice with AKI, the team treated the animals with endothelin-blocking medicines, which resulted in lower blood pressure, less inflammation and reduced scarring in the kidneys.

Those that were treated with the endothelin-blocking medicines also had more relaxed blood vessels and kidney function was improved, compared with untreated mice.

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

Dr Bean Dhaun, senior clinical lecturer and honorary consultant nephrologist at the University of Edinburgh’s Centre for Cardiovascular Science, added: “As these medicines are already available for use, I hope that we can move quickly to see if the same beneficial effects are seen in our patients.”