For the first time in 20 years, two new classes of drugs are available for the treatment of diabetic kidney disease, the most common cause of kidney failure. Both are extremely effective, safe, and relatively affordable. However, very few people with kidney disease are using these innovative drugs. We can only unlock these benefits if there is greater awareness among doctors, patients and the community at large about kidney disease and the tools we have to combat it.
Treatment options remain limited. Dialysis hasn’t progressed much in the last 50 years and involves being hooked up to a blood-filtering machine for hours, several times a week. Kidney transplantation remains the only cure for kidney failure, but it is only suitable for some patients and the supply of donor organs is limited. In the 1990s, we began using drugs to lower blood pressure, especially ACE inhibitors and angiotensin receptor blockers. These helped, but they only reduced the risk of kidney failure by about 20%.
In recent years, everything has changed. We have two new classes of drugs, SGLT2 inhibitors have been pioneers in identifying their benefits. SGLT2 inhibitors are probably the single most effective treatment we have, reducing the risk of kidney failure by 30-40%. They have a variety of additional benefits, including reducing the risk of heart failure and stroke, lowering blood pressure, and reducing weight. And they’re remarkably easy to take, just one tablet once a day.
Another drug called fineronone is currently being tested in a broad portfolio of other potentially kidney-protective drugs.
The challenge is to raise awareness of the new weapons in our arsenal to combat kidney disease. Information about new treatments can take many years to reach the medical community. We need communication between governments, researchers, and health professionals to understand what these new tools are and how they can best be used in the real world.
If we can increase acceptance of these innovative drugs in people with kidney disease, the frightening rise we’ve seen in kidney failure in recent decades should not only level off, but slow down. And that will lead to broader benefits for individuals, their communities, and our society as a whole.
Information Provided by the University of New South Wales.