Study reveals novel intervention for diabetic kidney risk

Adiponectin improves diabetic kidney function in mice.

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Researchers at the University of Bristol have discovered how a hormone can shield the kidney’s blood arteries from the harm that diabetes causes. By doing this, the group has found a possible early therapeutic approach to stop or lessen the development of kidney damage in diabetics. The study was published in Diabetes and was partially supported by Kidney Research UK.

Diabetes is a significant cause of kidney failure in the UK. About one in five people with diabetes will need kidney disease treatment in their lifetime, and nearly one in three of those who need dialysis or a transplant have diabetes. Both the patients and the NHS bear the financial burden of these therapies. Diabetes causes kidney damage gradually over the years, frequently as a result of elevated blood sugar levels.

This damages the glycocalyx, a vital layer in kidney filters. When injured, it can’t effectively prevent proteins like albumin from leaving the body through urine, an early sign of kidney disease in diabetes.

Image showing A glomerulus (kidney filter) from a patient with diabetes. The diabetic patient has no visible glycocalyx within the blood vessels.
A glomerulus (kidney filter) from a patient with diabetes. The diabetic patient has no visible glycocalyx within the blood vessels Credit: University of Bristol

The hormone adiponectin, produced by fat cells, decreases inflammation, improves the body’s sugar usage, and targets blood vessels. Adiponectin levels are frequently low in diabetics, but it can protect kidneys by halting the loss of albumin in the urine. In lab models of diabetic kidney disease (DKD), adiponectin was found to lessen glycocalyx damage and make it thicker, reducing vessel leakage.

Dr. Rebecca Foster, Associate Professor of Microvascular Medicine in the Bristol Medical School: Translational Health Sciences (THS) and senior author of the study, explained: “We knew that adiponectin was protective, but we wanted to understand whether it might be acting by supporting the barrier function of the blood vessels to stop them from becoming leaky. We were excited because it was the first time this fat hormone had been shown to play a role in glycocalyx health. It’s a new mechanism of action.”

According to recent research, focusing on the adiponectin pathway may protect the glycocalyx in diabetes, thereby averting the development of diabetic kidney disease (DKD). Dr. Aisling McMahon of Kidney Research UK stressed the need to avoid severe kidney problems in diabetes, save patients from grueling therapies, and lessen the financial strain on the National Health Service (NHS).

Targeting the adiponectin pathway might offer a new way to prevent DKD, paving the way for new preventive treatments through further research. The study shows how important it is to act early to lower the risk of kidney disease in people with diabetes. 

Doctors and researchers could create new ways to prevent kidney problems if they focus on the adiponectin pathway. This could improve healthcare for these patients and lower healthcare expenses.

Journal reference:

  1. Sarah Fawaz; Aldara Martin Alonso et al., Adiponectin Reduces Glomerular Endothelial Glycocalyx Disruption and Restores Glomerular Barrier Function in a Mouse Model of Type 2 Diabetes. Diabetes. DOI: 10.2337/db23-0455.
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