Recent clinical trials show a commonly used blood pressure medicine, known as spironolactone, is an effective treatment by reducing protein leak into the urine. However, despite its positive effect, the drug can have adverse side effects, causing problems including high blood potassium levels (hyperkalaemia) in patients, making clinicians reluctant to use it.
Researchers from Bristol Medical School, in collaboration with international colleagues, aimed to understand how spironolactone prevents damage to the kidneys.
They found that the drug has a protective effect by helping preserve the gel-like glycocalyx layer on the surface of blood vessels within the kidney. Using novel alternative therapeutics to slow down glycocalyx layer degradation in diabetes directly could now help them recreate the same effect but without adverse side effects.
Paper: 'Mineralocorticoid receptor antagonism in diabetes reduces albuminuria by preserving the glomerular endothelial glycocalyx' by Matthew J. Butler, Simon C. Satchell et al. in JCI Insight [open access]