Latest news with #chronickidneydisease
Medscape
28-05-2025
- Health
- Medscape
NICE Approves Sparsentan for Kidney Disease Treatment
The National Institute for Health and Care Excellence has recommended sparsentan (Filspari, Vifor Pharma) for treating primary immunoglobulin A nephropathy in adults. The recommendation reverses NICE's February decision to reject NHS funding for the drug. The regulator had previously said available evidence did not demonstrate value for money. The manufacturer provided additional analyses and agreed to a price discount, leading to the positive recommendation. Clinical Benefits Demonstrated Sparsentan reduces urine protein-to-creatinine ratio (UPCR) more effectively than standard treatment. The drug may also better maintain kidney function, NICE said. In its final draft guidance, the regulator recommended sparsentan for IgAN patients with a urine protein excretion of 1.0 g/day or more, or a UPCR of 0.75 g/g or higher. Treatment should cease after 36 weeks if a patient's UPCR remains at or above 1.76 g/g and has not reduced by at least 20%. Significant Patient Impact IgAN affects more than 18,000 people in England. It ranks among the most common causes of chronic kidney disease and kidney failure. Over 4200 people with chronic kidney disease could benefit from NICE's recommendation. Standard care for IgAN includes angiotensin-2 receptor blockers such as irbesartan. Mechanism of Action Sparsentan works by blocking the receptors for two hormones —endothelin-1 and angiotensin II — that cause kidney damage. By blocking these receptors, the drug reduces the amount of proteinuria and slows down the progression of kidney damage. Clinical trial evidence has shown that sparsentan reduces UPCR more than irbesartan. Evidence also suggests that sparsentan is better at maintaining kidney function than irbesartan, but this was uncertain, NICE explained. PROTECT Study Results The regulator's recommendation was informed by the outcome of the PROTECT study. The double-blind, randomised, active-controlled, phase 3 trial included patients aged 18 years or older with biopsy-proven primary IgAN and proteinuria of at least 1.0 g daily despite maximised renin-angiotensin system inhibition for a minimum of 12 weeks. Patients were randomly assigned to either receive 400 mg of oral sparsentan or 300 mg of oral irbesartan, both taken once daily. The sparsentan group showed slower rates of estimated glomerular filtration rate (eGFR) decline. At 36 weeks, sparsentan had significantly reduced proteinuria, a reduction that continued throughout the study. At 110 weeks, proteinuria, as determined by the change from baseline in UPCR, was 40% lower in the sparsentan group compared with irbesartan patients. The composite kidney failure endpoint was reached by 9% of patients in the sparsentan group compared with 13% of those in the irbesartan group. The researchers concluded that treatment with sparsentan versus maximally titrated irbesartan in patients with IgAN resulted in significant reductions in proteinuria and preservation of kidney function. Treatment Advantages Sparsentan is taken as a once-daily tablet for long-term use. This differs from targeted-release budesonide, which is limited to 9 months' duration. NICE said it expected the treatment to reduce NHS pressure by preventing or delaying progression to end-stage renal disease requiring dialysis or transplant. Helen Knight, director of medicines evaluation at NICE, highlighted the limited treatment options available for the disease. She said that sparsentan offered long-term benefits to patients and 'could make a huge difference to people's lives by delaying kidney failure'. Fiona Loud, policy director at Kidney Care UK, welcomed the guidance. She noted that IgAN typically affects younger patients, disrupting lives when people have young families or are starting careers. 'We're pleased that this new treatment for IgAN will now be an option for patients who need it,' Loud said.
Medscape
22-05-2025
- Health
- Medscape
Urine Metabolites Could Forecast Renal Outcomes in T2D
Increased levels of urine metabolites choline and dimethylglycine were independently associated with an increased risk for renal events and all-cause mortality in patients with type 2 diabetes (T2D), with evidence suggesting that tubular stress partly mediated the link between disrupted choline metabolism and the gradual decline in kidney function in this population. METHODOLOGY: Although elevated plasma choline levels are linked to a greater risk for kidney disease progression in patients with T2D, the relationship between choline metabolism in the kidneys and the progression of kidney disease is not well understood. Researchers analyzed data of 1894 patients with T2D (mean age, 57.4 years; 51.1% men) from a regional hospital and a primary care facility in Singapore to study the role of urine metabolites of the choline oxidation pathway in the progression of chronic kidney disease (CKD). Urine metabolites (choline, betaine, dimethylglycine, and sarcosine) were quantified or semiquantified using liquid chromatography-mass spectrometry. Variables such as heart conditions, blood pressure, tubulopathy biomarkers, and estimated glomerular filtration rate (eGFR) were either self-reported or measured, with patients being followed-up using electronic medical records and in-person research visits. The primary outcome was a composite of incident end-stage kidney disease (defined as having a sustained eGFR < 15 mL/min/1.73 m2, undergoing maintenance dialysis, or death from renal causes) or the doubling of serum creatinine levels. TAKEAWAY: Overall, 263 participants experienced renal events over a median follow-up of 9.2 years. Those who experienced renal events had higher baseline levels of urine choline (median, 32.1 vs 16.9 µM) and dimethylglycine (median, 1.25 vs 0.74 units) than those who did not. Each SD increase in levels of urine choline (adjusted hazard ratio [aHR], 1.33) and dimethylglycine (aHR, 1.30) was associated with an increased risk for the composite renal outcome ( P < .001 for both). < .001 for both). Researchers postulated that tubular stress may partly mediate the link between urine choline, dimethylglycine, and the risk for adverse renal outcome. After adjusting for clinical risk factors, each SD increase in levels of urine choline and dimethylglycine was associated with a 1.2-fold and 1.17-fold increase in the risk for all-cause death, respectively ( P < .05 for both). IN PRACTICE: 'High levels of urine choline and dimethylglycine in the choline oxidation pathway were strongly associated with a high risk for CKD progression independent of traditional risk factors in individuals with type 2 diabetes. Dysregulation of choline metabolism in the kidney may be involved in pathogenesis of tubulopathy and plays a role in progressive loss of kidney disease,' the authors wrote. SOURCE: This study was led by Jian-Jun Liu, Clinical Research Unit, Khoo Teck Puat Hospital (KTPH) in Singapore. It was published online on May 13, 2025, in Journal of Clinical Endocrinology & Metabolism . LIMITATIONS: It could not be inferred whether urine metabolites caused kidney disease progression. Residual confounding could not be ruled out due to observational nature of this study. Some of the urine metabolites were semiquantified with relatively high technical differences. DISCLOSURES: This study received grants from KTPH STAR and Singapore National Medical Research Council. The authors reported having no relevant conflicts of interest. This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication. Medscape Medical News © 2025 WebMD, LLC Cite this: Urine Metabolites Could Forecast Renal Outcomes in T2D - Medscape - May 22, 2025.
CNET
20-05-2025
- Health
- CNET
13 Best Superfoods to Boost Kidney Health
It's no secret that your kidneys are really important for your overall health. According to the US Centers for Disease Control and Prevention, more than one in seven adults in the United States has chronic kidney disease. Your kidneys work around the clock to filter out waste and excess fluid, helping to prevent serious health problems like heart disease, infections, anemia, depression and even loss of appetite. Your diet and gut health also play a major role in your wellness, especially when it comes to keeping your kidneys healthy. There are 13 superfoods you should keep in mind when considering natural ways to give your kidney health a boost. Read more: 6 Important Blood Tests You May Need for Your Overall Health 13 superfoods for kidney health 1. Cabbage This nutrient-dense vegetable is low in both potassium and sodium while packing in fiber, vitamins C and K and more. Plus, cabbage is versatile. You can use it in salads and slaws, but you can also use it as a wrap for tacos, sandwiches and more. 2. Fatty fish Fish delivers protein, and when you choose a fatty fish like tuna, salmon or trout, you're also getting omega-3 fatty acids. Omega-3 fats may help reduce fat levels (triglycerides) in the blood and may also lower blood pressure, according to the National Kidney Foundation. If you have CKD, you may need to keep an eye on the phosphorus and potassium levels of the fish you choose. The National Kidney Foundation has a chart you can use to determine levels in specific types of fish. Although, it's best to consult with your doctor. Jacobs3. Bell peppers Like cabbage, bell peppers pack in lots of good nutrients with low levels of potassium. With them, you get vitamins B6, B9, C and K, plus fiber. They deliver antioxidants too. You can slice them and eat them with dips or roast them and add them to dinner. 4. Cranberries Cranberries help to prevent urinary tract infections. These usually stay in your bladder, they can travel up to your kidney, making kidney problems worse. Fortunately, regularly consuming cranberries can help you avoid this unwelcome situation. Plus, cranberries have antioxidants that can help fight inflammation, and they can boost your heart and digestive health. It turns out, these tart berries aren't just for the Thanksgiving table. 5. Blueberries We've talked about some of the best foods for kidneys, but you can take it a step further. The question is: What foods help repair kidneys? Blueberries deliver. With high levels of antioxidants and loads of vitamin C and fiber, blueberries are all-around healthy. They can also help to reduce inflammation and support bone health, reversing some of the issues that can come with CKD. 6. Dark, leafy greens There are plenty of reasons to turn to dark, leafy greens like spinach or kale. They deliver so many nutrients that they can help you get key vitamins and minerals, plus immunity-boosting benefits. Be advised that greens can come with a decent amount of potassium. If you have CKD, talk to your doctor before adding more of these to your diet. 7. Olive oil Rich in antioxidants and healthy fatty acids, olive oil can boost your overall wellness. A study from Harvard University found that olive oil may lower cholesterol levels and the risk of cardiovascular disease, dementia and some types of cancer. Beyond all this, it can help you add flavor to dishes without turning to salt or butter. To get more antioxidants, choose unrefined or cold-pressed olive oil that's virgin or extra virgin. 8. Garlic Another antioxidant-rich, inflammation-fighting food, garlic also contains a specific compound called allicin. For people with CKD, allicin — an active compound found in garlic — worked just as effectively to help protect kidney health as a prescription drug. If you're looking for the best foods for your kidneys, garlic has to make the list. Plus, it's an excellent way to add flavor when you're skimping on salt. 9. Onions From the same family as garlic, onions give you another excellent and salt-free way to add flavor (bonus points if you saute them in olive oil). Onions also deliver important nutrients like vitamins B6 and C, manganese and copper. They also contain quercetin, a chemical that can help your body fight cancer, and organic sulfur compounds that can reduce your risk of high blood pressure, stroke and heart disease. Getty Images 10. Cauliflower Cauliflower brings the crunch, paired with plenty of vitamins C, B6, B9 and K, along with fiber. It also contains compounds your body can use to neutralize certain toxins, a big help when your kidneys aren't doing their best filtration work. Cauliflower does contain some potassium and phosphorus, though, so while it makes the list of foods good for kidneys, people with CKD may want to moderate their intake. 11. Egg whites Egg whites are specifically recommended for people with kidney problems. They give you a way to increase your protein levels -- which can be important with later-stage CKD, especially if you're on dialysis. 12. Arugula Arugula is packed with nutrients your body needs like magnesium, iron, calcium and vitamins A, B9, C and K. Plus, it's antioxidant-rich and has glucosinolates, which can help your body protect itself against a range of cancer types. You can eat arugula raw (it's a great salad base), but you can also sprinkle it over whatever you're whipping up. It's great on pizzas, in omelets and with pasta, for example. 13. Apples Apples deliver the cancer-fighting quercetin and fiber that can help to keep your cholesterol and blood sugar at healthy levels. They've got plenty of antioxidants. Better yet, they're easy to work into your diet. Leave a bowl of apples on your counter and you'll have a kidney-healthy, grab-and-go snack whenever you need one.
