The patients with kidney dysfunction are most likely at risk of progressive kidney damage which cannot be reversed.

 

 

 

 

In view of increased prevalence of kidney disease, the scientists strive to find novel treatment approaches. Fortunately, they identified some breakthroughs that improve the quality of life and life expectancy of the patients with kidney dysfunction. In this review, we emphasize some of those breakthroughs in the treatment of kidney failure and future perspectives.

 

1. Novel drug offers new hope to kidney failure patients

Experts identified a new treatment approach for patients with monoclonal gammopathy with renal significance (MGRS). This condition involves formation of abnormal proteins by monoclonal plasma cells of bone marrow. These proteins are then deposited in the kidney leading to inflammation and reduced ability to function properly.

 

Although the kidney transplant is considered as a last resort for kidney disease, it could not fix the problem of MGRS. The scientists then discovered a drug called daratumab, which was approved for treating multiple myeloma, is effective in managing MGRS. The drug targets the plasma cells producing abnormal proteins and halts the progression of kidney damage. This novel approach of impacting the plasma cells led a way to further discover the effects of the drug in restoring kidney function.

 

2. New drug tackles polycystic kidney disease

Till date, experts discovered many autosomal dominant PKD-specific therapies that address the effects of the disease. Researchers have now identified a potential novel drug for treating polycystic kidney disease. The drug, called RGLS4326, inhibited microRNA which is responsible for the progression of ADPKD in animal models. The study found that the drug slowed the growth of the cyst and also doubled the life spans of some mice. Experts say that further study in humans is required to evaluate its safety and efficacy in treating ADPKD.

 

3. Alpha-lipoic acid – A miracle kidney cleanser

Recent study identified that alpha-lipoic acid, a dietary supplement, has staggering ability to prevent and treat kidney stones. Previously, the experts were in belief that the antioxidant property of lipoic acid treats cystinuria by increasing the metabolism of cystine. The current study found the new role of the supplement in treating kidney stones by increasing the solubility of cystine crystals in animal models. Furthermore, the drug is able to slow the development of the stones. Thus, the amazing effects of the dietary supplement provide a new hope for the patients suffering from cystunuria.

 

4. A non-invasive alternative promises kidney cancer cure

 A recent study reveals that the focused form of radiation called stereotactic radio-ablative therapy is effective in treating metastatic kidney cancer. Systemic therapy is considered as the gold standard therapy for metastatic kidney cancer, albeit associated with severe side effects. The experts say that this non-invasive alternative offers 90% cure or delay the treatment with systemic therapy allowing them to lead a better life without side effects.

 

5. Targeting the sweet spot prevents chronic kidney disease

Reperfusion injury is one of the major causes of chronic kidney disease. It is known that the pro-inflammatory molecules are released in response to reperfusion injury. When there is an increased release of these molecules, it may lead to organ damage. In view of this, the researchers attempted to target these molecules for drug development. In response to ischemia, the molecules enter the affected organ and communicate via a receptor molecule called CD11b/CD18. The current study identifies a novel therapeutic approach by blocking these molecules without activating the receptor using specific antibodies paved a way to prevent CKD.

 

6. Bionic kidney to replace dialysis

In another new study, the researchers used conditionally immortalized human renal proximal tubular epithelial cells (ciPTECs) on polyethersulfone-based hollow fiber membranes. They found that the cell monolayer has a similar function to that of a living membrane.

 

7. Novel drug to treat advanced renal cell carcinoma

As for now, there is no treatment modality that cures metastatic or advanced renal cell carcinoma. A recent study compared two potential drugs (Cabozantinib and sunitinib) for treating metastatic kidney cancer. Cabozantinib was approved as second-line treatment for metastatic kidney cancer. The study used cabozantinib, a vascular endothelial growth factor-targeted agent, as first-line drug for those patients. With the study, researchers identified the superiority of cabozantinib over sunitinib in enhancing the quality of life of patients with advanced renal cell carcinoma.

 

8. Prostate drug for kidney stones

Tamsulosin is a drug approved for the treatment of enlarged prostate. There are many evidences that support the effective use of tamsulosin in prostate enlargement. Besides dilating the obstructing prostate in men, the drug also can dilate the ureter and promotes the passage of jagged kidney stones. The current study found that the patients who received tamsulosin passed the large sized kidney stones more frequently than the control group. This evidence suggests that the tamsulosin can replace complicated surgical procedures for removal of kidney stones.

 

9. A biopolymer as a potent drug carrier

Use of kidney-targeted drug delivery method serves a fascinating approach in enhancing the therapeutic effects of the drug. Researchers have developed kidney-targeting construct for drug delivery. In the current study, the protein-based carriers such as elastin-like polypeptides (ELP) are used to deliver the drug. ELP is converted to KTP-ELP, a kidney-targeting construct, was found to be five times efficacious than non-targeted ELP.

 

The scientists from around the world strive to identify novel therapeutic approaches for treating the kidney diseases. Several new attempts are being made to discover the drugs with enhanced therapeutic efficacy and other related characteristics.

 

 

References

• Sachin H, Ronak L et al. microRNA-17 family promotes polycystic kidney disease progression through modulation of mitochondrial metabolism, Nature Communications, 2017; 8: 14395
• Zee T, Bose N et al. Lipoic acid treatment prevents cystine urolithiasis in a mouse model of cystinuria. Nature Medicine, 2017; 
• Wang CJ, Christie A et al. Safety and Efficacy of Stereotactic Ablative Radiation Therapy for Renal Cell Carcinoma Extracranial Metastases. International Journal of Radiation Oncology*Biology*Physics, 2017; 98 (1): 91
• Dehnadi A, Cosimi AB et al. Prophylactic orthosteric inhibition of leukocyte integrin CD11b/CD18 prevents long-term fibrotic kidney failure in cynomolgus monkeys. Nature Communications, 2017; 8: 13899 
• Choueiri TK, Halabi S et al. Cabozantinib Versus Sunitinib As Initial Targeted Therapy for Patients With Metastatic Renal Cell Carcinoma of Poor or Intermediate Risk: The Alliance A031203 CABOSUN Trial. Journal of Clinical Oncology, Nov 2016.
• Maltese G, Fountoulakis N et al. Perturbations of the anti-ageing hormone Klotho in patients with type 1 diabetes and microalbuminuria. Diabetologia, 2017