US scientists have made a discovery that could help slow the progression of diabetic kidney disease (DKD).
Researchers from Joslin Diabetes Centre devised a new approach to treating DKD, also known as diabetic nephropathy, which could prevent abnormalities developing within kidney cells.
The Joslin team had set out to investigate which biological mechanisms could protect and prevent the kidneys from becoming damaged if high blood glucose levels consistently occur.
They had been expecting to find high levels of enzymes that process blood sugar in unhealthy kidneys. However, they discovered the higher enzyme levels were associated with the healthy kidneys instead.
A further discovery, which also surprised the team, was made when they exposed mice kidney cells which filter the blood, called “podocytes”, to high levels of glucose.
It has long been known that damaging the cell’s power generators, called the mitochondria, can lead to kidney disease, but the recent findings showed the opposite effect.
“Rather than having damaged mitochondria, somehow these cells, when their glucose metabolism is activated, stimulate themselves to make new mitochondria, so the mitochondria actually work better,” explained Dr George King, Joslin’s chief scientific officer and professor of medicine at Harvard Medical School.
The next step during the research was to apply an enzyme known as PKM2 to glucose-processing pathways. After activating PKM2 using a compound, they found it was able to prevent abnormalities in the mice kidney cells.
Dr King said: “Anything we could do to delay the progression of diabetic kidney disease would be very helpful, because the need is great and there hasn’t been a new drug in decades. This approach also may prove help defend against eye, nerve or other complications of diabetes.”
The findings have been published in the Nature Medicine journal.

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