Intense Kidney Protection

Kidney disease risk may be reduced by intensive type 1 diabetes therapy

(RxWiki News) Kidney disease is a big worry for anyone with type 1 diabetes. For a while, it seemed there were few good approaches to slow the process that leads to kidney disease in these patients. Now, there may be a way.

The risk of kidney disease was cut in half among type 1 diabetes patients who received intensive therapy (tight blood sugar control).

"Avoid kidney disease by keeping tight control of your blood sugar."

As part of the Diabetes Control and Complications Trial (DCCT), Ian H. de Boer, M.D., of the University of Washington, and colleagues set out to see what kind of diabetes treatment was best for preventing kidney disease in people with type 1 diabetes.

People can develop end-stage renal disease (the complete or almost complete failure of the kidneys) when they have an impaired glomerular filtration rate (GFR) - the volume of fluid filtered from the kidney. Dr. de Boer and colleagues wanted find out if intensive therapy or conventional therapy was more effective at preventing impairment of the GFR in people with type 1 diabetes.

The goal of conventional type 1 diabetes treatments is to prevent symptoms of high blood sugar. Intensive therapy, on the other hand, is designed to keep patients' blood sugar levels as close to normal as possible.

The researchers found that patients who received an average of 6.5 years of intensive therapy had a 50 percent reduced risk of impaired GFR.

Throughout the course of the study, 24 participants in the intensive therapy group developed GFR impairment, compared to 46 in the conventional therapy group. Of those who developed GFR impairment, eight intensive therapy patients and 16 conventional therapy patients developed end-stage renal disease.

The study's authors conclude, "The long-term risk of an impaired GFR was significantly lower among persons treated early in the course of type 1 diabetes with intensive diabetes therapy than among those treated with conventional diabetes therapy."

The study - which was funded by the National Institute of Diabetes and Digestive and Kidney Diseases - is published in the New England Journal of Medicine

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Review Date: 
November 21, 2011