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. 2012 Sep;32(5):437-44.
doi: 10.1016/j.semnephrol.2012.07.006.

Can existing drugs approved for other indications retard renal function decline in patients with type 1 diabetes and nephropathy?

Alessandro Doria  1 , Monika A Niewczas, Paolo Fiorina
Affiliations

Can existing drugs approved for other indications retard renal function decline in patients with type 1 diabetes and nephropathy?

Alessandro Doria et al. Semin Nephrol. 2012 Sep.

Abstract

Mounting evidence from human, animal, and in vitro studies indicates that existing drugs, developed to treat other disorders, also might be effective in preventing or slowing the progression of diabetic nephropathy to end-stage renal disease. Examples of such drugs include the urate-lowering agent allopurinol, the anti-tumor necrosis factor agents etanercept and infliximab, and the immunomodulating drug abatacept. Because some of these medications are already on the market and have been used for a number of years for other indications, they can be tested immediately in human beings for a beneficial effect on renal function in diabetes. Special emphasis should be placed on evaluating the use of these drugs early in the course of diabetic nephropathy when renal damage is most likely to be reversible and interventions can yield the greatest delay to end-stage renal disease.

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Figures

Figure 1
Figure 1
Risk of early GFR loss in the JKS during 4–6 years of follow-up according to baseline serum UA levels (from Ficociello et al.)
Figure 2
Figure 2
GFR trajectory of a hypothetical type 1 diabetes patients who developed diabetes at age 10 and started to lose renal function at age 25 at a constant rate of 4 ml/min per year. The solid line represents the GFR trajectory without treatment, the dotted lines are the trajectories with an intervention that reduce GFR decline from 4 to 2 ml/min/year and is started at a GFR of 90 ml/min or at a GFR of 45/ml/min.
Figure 3
Figure 3
Course of urinary albumin excretion (triangles) and renal function (circles) over the 14 years preceding the onset of CKD3 in a Joslin type 1 diabetic patient.
See this image and copyright information in PMC

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