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Can diabetic eye disease treatments affect kidney function?

20 February 2024

Dr Bang Zheng and Professor Laurie Tomlinson from London School of Hygiene and Tropical Medicine have been awarded a Kidney Research UK-Stoneygate project grant of £80,900 to investigate whether drugs called ‘vascular endothelial growth factor (VEGF) inhibitors, which are used to treat the eye damage that is common in people with diabetes, could lead to progression of kidney damage.  

Dr Bang Zheng (left)
Dr Bang Zheng (left)
Professor Laurie Tomlinson
Professor Laurie Tomlinson

The problem with diabetic eye disease treatments

In people with diabetes, abnormal blood vessels can form in the back of the eye, leading to vision problems often referred to as diabetic eye disease. VEGF is a substance that plays a role in the growth of blood vessels, but in diabetic eye disease, too much VEGF causes abnormal and leaky blood vessels to form and grow in the eye. Medications called VEGF inhibitors can block the action of VEGF, which helps to prevent the growth of problematic blood vessels and slow the progression of diabetic eye disease.  

These medications are often delivered by injection directly into the eye, and doctors have recently raised the possibility that this might cause side effects elsewhere in the body, such as high blood pressure and decline in kidney function. However, we don’t yet know that there is any direct relationship with the injections, or how common or serious any problems might be. 

The solution 

The team will analyse previously collected, anonymous patient information to understand whether VEGF inhibitor treatment causes high blood pressure and decline in kidney function, and whether it increases the risk of heart disease in patients with diabetic eye disease. 

What this means for patients

This work will not only help to inform patients about the potential risks of VEGF inhibitor treatment but also inform doctors about how best to monitor patients who have been treated with VEGF inhibitors. 

Laurie said: “I see many patients with advanced kidney problems in clinic who are receiving VEGF inhibitor injections for eye problems. From extensive existing clinical trial data we do not have any evidence that these drugs are damaging the kidneys but it is important to study whether there is any risk. Even if there is no evidence of direct harm, we can explore how commonly these problems occur among patients with kidney disease and identify those at highest risk who may need extra monitoring. Additionally, if there is evidence that these drugs are harmful to kidneys the findings of this research may also lead to differences in treatment or trials of new ways to prevent the associated kidney damage.” 

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