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Scientists discover potential target for treatment of diabetic kidney disease

13 May 2021

In a recent study published in Diabetologia, researchers at the University of Bristol discovered a protein that may play a crucial role in the development of kidney disease in people with type 2 diabetes.

With the help of funding from Kidney Research UK and the Medical Research Council, the team identified a potential way to stop people with type 2 diabetes from developing diabetic kidney disease: the most common cause of end-stage kidney failure worldwide.

Nephron, functional unit of the kidney, the structure that actually produces urine in the process of removing waste and excess substances from the blood.

Type 2 diabetes affects kidney health

The kidneys are responsible for filtering waste products from the blood. They also make sure that important proteins do not escape from the body into the urine. The filtering units of the kidneys are called glomeruli and they are made up of clusters of blood vessels and special cells called podocytes. Podocytes have finger-like arms and they line the outside of the blood vessels and help to prevent proteins and other large molecules from being filtered out of the body. 

Diabetes can cause damage to these delicate filtering systems, causing them to leak and not work as well, which can eventually lead to kidney failure. We know that podocytes are damaged and lost very early on in diabetic kidney disease, causing the filtering unit to stop working properly. If researchers could understand what is causing this damage, then new therapies for diabetic kidney disease could be developed 

What did they discover?

Researchers studied kidney biopsy samples from people with type 2 diabetes and kidney cells in dishes and discovered that the levels of a protein called IGFBP-1 were lower in the glomeruli of people with type 2 diabetes, particularly in the podocytes. The team also found that loss of IGFBP-1 was harmful to the function and health of these podocyte cells. 

What do these findings mean for kidney patients?

These findings suggest that treatments that increase the levels of IGFBP-1 have the potential to help slow down or stop the progression of kidney disease in people with type 2 diabetes. 

Lead author Dr Abigail Lay said: We know that podocytes are damaged in diabetes - and that this is one of the major driving factors causing kidney disease in these patients. From this study, we've shown that a loss of IGFBP-1 could be one contributing factor to podocyte damage. We hope that this will lead future work to investigate treatments protecting IGFBP-1 levels, and whether protecting kidney IGFBP-1 levels early in type 2 diabetes could prevent kidney damage. 

Professor Richard Coward, who led the research said: This work suggests that treatments that can increase the level of IGFBP-1 in the kidney may be beneficial in treating diabetic kidney disease. This is important as diabetic kidney disease is the leading cause of kidney failure requiring dialysis or a kidney transplant in the world”. 

Find out more

Read the full paper.

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