Researchers from the University of Bristol have identified a potential early treatment strategy to prevent or slow down the progression of kidney disease in patients living with diabetes.
Funded by Kidney Research UK and published in Diabetes, researchers uncovered a mechanism where blood vessels in the kidney are protected by a hormone from damage caused by diabetes.
Currently the leading cause of kidney failure in the UK, diabetes is a chronic disease that occurs when the pancreas does not produce enough insulin or when the body cannot effectively use the insulin it produces.
Additionally, it is estimated that in 2023, dialysis and kidney transplant surgery with follow-up care cost the NHS £1.05bn and £293m, respectively.
One way in which diabetes causes kidney damage is by disrupting the glycocalyx, a thin gel-like layer lining the surface of the blood vessels in the kidney, due to high blood sugar levels over a long period of time and can cause the presence of a protein known as albumin to be found in the urine.
Researchers used several laboratory models of diabetic kidney disease (DKD) to show that adiponectin, a hormone produced by fat cells in the body that helps it use sugar more effectively, reduce inflammation and prevent blood vessel damage, could reduce glycocalyx damage, increase its thickness and reduce the leakiness of vessels.
Describing the approach as a “new mechanism of action,” Dr Rebecca Foster, associate professor of microvascular medicine, Bristol Medical School: Translational Health Sciences, said that this is “the first time that this fat hormone has been shown to play a role in glycocalyx health”.
Findings from the study suggest that targeting the adiponectin signalling pathway could help to protect the glycocalyx in people with diabetes and potentially prevent the onset of DKD in this at-risk group.
Dr Aisling McMahon, executive director, research and policy, Kidney Research UK, commented: “These findings suggest that targeting the adiponectin pathway might provide a completely new approach to preventing DKD” and “could lead towards the development of a new preventative treatment for this at-risk group”.