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Finding the best way to prevent kidney failure in diabetic kidney disease

15 January 2024

Professor Simon Satchell from the University of Bristol has been awarded a research project grant of £193,000 to identify new targets for the treatment of diabetic kidney disease (DKD).

What is the problem?

DKD develops in up to 45% of diabetic patients, in both Type 1 and Type 2 diabetes. 

The first sign of DKD is finding increased levels of the blood protein albumin in the urine, which happens when the tiny filters of the kidney (known as ‘glomeruli’) become leaky. The glycocalyx is a gel-like layer in the glomeruli that filters the blood and keeps albumin in the bloodstream. People with diabetes produce too much of certain proteins called metalloproteinases (MMPs), and these can damage the glycocalyx. There are medications that inhibit MMPs, but these are not specific to the kidney and would cause side effects. 

A detailed image of a glomerulus
A single glomerulus (kidney filter) on a microscope slide. The glycocalyx, lining the glomerular capillaries, is in green. Image credit: Dr Michael Crompton

The solution for kidney failure in diabetic kidney disease

Simon and the team will investigate the cells that produce the glycocalyx in the laboratory and use genetic techniques to stop them from making individual MMPs. This will help to identify which type of MMP is the most important one to block to protect the glycocalyx in diabetic conditions. The team will then use gene therapy to deliver a genetic message to cells which tells them not to make that MMP in laboratory models and see if this approach lessens glycocalyx damage. 

What this might mean for patients with diabetic kidney disease

If the team can identify which MMP is the most important to block to prevent DKD, this will provide a target for both developing more specific drugs and for gene therapy strategies. DKD is a common and serious kidney disease, so this project has the potential for huge impact and patient benefit. 

Professor Simon Satchell
Professor Simon Satchell

“Our recent research has revealed the important role of glycocalyx damage in kidney disease in diabetes. This award will enable us to build on this by discovering a way protect the glycocalyx. We hope that we will be able to use this as a treatment for kidney disease in people with diabetes to prevent kidney failure.” Professor Simon Satchell

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