UC San Diego Logo Diabetic nephropathy, the leading cause of end-stage kidney disease (ESKD) in the United States appears as a common complication of diabetes. In this condition, the kidney cells are supposedly damaged due to high blood sugar levels. In a major breakthrough, investigators from the University of California, San Diego School of Medicine, the National Institutes of Health (NIH) and the Mayo Clinic discovered that an experimental anti-fibrotic and anti-inflammatory drug called pirfenidone can treat those suffering from diabetic nephropathy.

The study included 77 patients diagnosed with diabetic nephropathy. Partcipants were divided into three study groups, one group received a high dose of pirfenidone (2400 mg); one group received a low dose of pirfenidone (1200 mg); and a control group. The rate of decline in kidney function was then monitored in all the three groups by measuring the estimated glomerular filtration rate, or eGFR. As a result, a remarkable improvement in the low-dose group was registered in the one-year study.

“We have previously found that pirfenidone slows progressive loss of kidney function in another chronic kidney disease, called focal segmental glomerulosclerosis,” elucidated Jeffrey B. Kopp, MD, NIH/NIDDK intramural researcher and Capt., USPHS. “By extending these findings to the most common chronic kidney disease – diabetic kidney disease – the present study suggests that pirfenidone may have broad utility to help patients maintain kidney function longer.”

Scientists were unable to figure out any benefit for those who were provided with the high dose. Hence, higher doses appear intolerable in the diabetic population with moderate to advanced chronic kidney disease. Additional investigations will be initiated to identify personalized biomarkers and determine which patients are most apt to show improvement on the drug. Pirfenidone may be also beneficial in the battle against other types of fibrotic diseases.

The study was published in the April 21 issue of the Journal of the American Society of Nephrology (JASN).