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A new historical clinical trial shows that a drug reduces the risk of kidney failure by a third in people with type 2 diabetes and kidney failure.
"For the first time in 18 years, we have a therapy for patients with type 2 diabetes and chronic renal failure that reduces renal failure," said Kenneth Mahaffey, MD, professor of medicine. at the Faculty of Medicine of Stanford University and co-principal investigator. of the trial. "Now, diabetic patients have a promising option to guard against one of the most serious risks of their disease."
The trial involved 4,401 participants in 34 countries.
The drug, canagliflozin, has been improving treatment for nearly two decades, currently the only approved treatment to protect kidney function in people with type 2 diabetes. In the trial, canagliflozin also reduced the risk of major cardiovascular events.
Canagliflozin increases the excretion of glucose by the kidneys. It has already been approved by the Food and Drug Administration to lower blood sugar levels in patients with type 2 diabetes and to reduce the risk of major adverse cardiovascular events in patients with type 2 diabetes and heart disease existing.
An article describing the findings of the CREDENCE essay was published today in The New England Journal of Medicine and presented at the World Nephrology Congress of the International Society of Nephrology in Melbourne. Mahaffey, director of the Stanford Clinical Research Center, is the lead author of the study. The lead author is Vlado Perkovic, MBBS, PhD, Executive Director of the George Institute for Global Health Australia and Professor of Medicine at the University of New South Wales in Sydney.
& # 39; Final test result & # 39;
"People with diabetes and kidney failure are at extremely high risk for kidney failure, heart attack, stroke and death," Perkovic said. "With this definitive test result, we now have a very effective way to reduce this risk by using a pill to take once a day."
The trial participants received the best available care for kidney disease according to current guidelines, a type of therapy called renin-angiotensin-aldosterone system blockade, or SRA. In addition, half were randomly selected to receive canagliflozin, while the other half received placebo.
The main findings of the study revealed that participants taking canagliflozin were 30% less likely than the placebo group to develop renal failure or die from kidney failure or cardiovascular disease . Their risk of renal failure or death from kidney failure was reduced by 34%, and the risk of hospitalization for heart failure or death from cardiac origin was reduced by 31%.
"Wanted" treatment
People with diabetes can develop kidney disease because prolonged high blood sugar harms the blood vessels of the kidney. In addition, diabetes often causes high blood pressure, which can stretch and weaken the blood vessels of the body.
Over the last two decades, physicians have relied heavily on the blockade of the RAAS to prevent deterioration of renal function in diabetic patients. Although blocking RAAS lowers blood pressure and delays the progression of renal failure, patients treated with this treatment still have a high risk of renal failure and cardiovascular disease, as well as death.
Given that the number of people with type 2 diabetes worldwide would increase from 20% to 510 million by 2030, "a drug like canagliflozin, which improves cardiovascular and renal outcomes, has been eagerly sought by patients with of type 2 diabetes and the ones for them, "said Mahaffey.
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Material provided by Stanford Medicine. Note: Content can be changed for style and length.
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