Drug 'canagliflozin' lowers the risk of kidney failure in diabetes patients

In a landmark clinical trial, researchers have found that a drug called canagliflozin decreases the risk of kidney failure by third in the patients' suffering from Type 2  diabetes and kidney disease.

The study involved 4,401 participants in 34 countries. 

"For the first time in 18 years, we have a therapy for patients with Type 2 diabetes and chronic kidney disease that decreases kidney failure," said senior author of the study.

The drug, canagliflozin, improves a nearly two-decades-old therapy, currently the only approved treatment to protect kidney function in people with Type 2 diabetes. In the trial, canagliflozin was  also found to reduce the risk of major cardiovascular events.

Canagliflozin increases the excretion of glucose through the kidneys. It has already been approved by the government to lower blood glucose in patients with Type 2 diabetes and to reduce the risk of major adverse cardiovascular events in patients with Type 2 diabetes and existing heart disease.

"People with diabetes and kidney disease are at extremely high risk of kidney failure, heart attack, stroke and death. With this definitive trial result, we now have a very effective way to reduce this risk by using a pill once a day," said the lead author of the study.


Participants in the trial received the best care available for kidney disease under the current guidelines, a type of therapy called the renin-angiotensin-aldosterone system, or RAAS, blockade. In addition, half were randomly selected to receive canagliflozin, while the other half were given a placebo.

The primary results of the study found that participants who took canagliflozin were 30 per cent less likely than the placebo group to develop kidney failure or die from either renal failure or cardiovascular disease.

Their risk of kidney failure or death from kidney failure was reduced by 34 per cent, and the risk of hospitalisation for heart failure or death due to cardiac causes decreased by 31 per cent.

People with diabetes can develop kidney disease because prolonged high blood sugar harms blood vessels in the kidney. In addition, diabetes often causes high blood pressure, which can stretch and weaken blood vessels in the organ.

For the past two decades, physicians have largely relied on RAAS blockade to prevent the deterioration of kidney function in diabetic patients. Although RAAS blockade lowers blood pressure and delays progression of kidney disease, patients undergoing this treatment remain at high risk for renal failure and cardiovascular disease, as well as death from these conditions.

Given that the number of people with Type 2 diabetes worldwide is estimated to rise by 20 per cent to 510 million in 2030, "a drug like canagliflozin that improves both cardiovascular and renal outcomes has been eagerly sought by both patients with Type 2 diabetes and clinicians caring for them," said the researcher.

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Study reveals genetic heart gene in isolated Cretan villages

Scientists have revealed a genetic variant in residents of northern Crete, who despite consuming lamb and cheese don't have the prevalence of heart problems, heart attacks and strokes found in much of the western world. 

The research published by the Wellcome Trust Sanger Institute focused on villagers in the municipality of Mylopotamos, with blood drawn from 250 residents to examine their DNA, revealing a genetic variant unique to the residents of Zoniana and Anogia. 

While the villagers consume a diet rich in animal fat, the variant appears to protect their hearts by decreasing the levels of cholesterol and 'bad' fats in the body. 

Scientists set out testing the genomes of thousands of Europeans, however were only able to find the same variant in one other individual residing in Tuscany, Italy.

Published in the journal Nature Communications, researchers are not yet sure about why this genetic variant exists or how it came to be. It could in fact be influenced by a number of factors, including lifestyle and environment, or could be a possible genetic mutation that has been passed on from one generation to the next given that the populations of the two villages are isolated high up in the mountains. 

"By studying isolated populations, we are able to identify those genetic variants that are at a higher frequency compared to cosmopolitan populations and this in turn increases our power to detect if these variants are disease causing," said researcher Lorraine Southam.

"With isolated populations, we can get a unique view into rare genetic variants that play important roles in complex human diseases."

Meanwhile, scientists are now examining other isolated populations including the Amish in the United States and the Inuit in northern Greenland in a bid to see whether isolation is part of maintaining their health. 

"We are finding new genetic variants we haven't seen before," said lead author Professor Eleftheria Zeggini, adding that the results revealed in the residents of Mylopotamos show the significance of examining the entire human genome rather than individual pieces to understand the genetic architecture of a population.

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