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Kidneys, how to protect them from diseases and new treatments

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“Prince of a thousand enemies”. Who read The Hill of Rabbits he will remember that this was the name of the ancestor of these animals. Likewise too the kidney, a noble organ like heart and brain, must be protected because it is under attack day after day from our bad habits, from hypertension and circulatory problems, even from environmental conditions that can facilitate the appearance of problems.

But the kidneys, like tireless workers, even if they suffer show few signs of their problems. And so they can be altered, progressively, without us realizing it. Result: According to recent studies by the Italian Society of Nephrology (SIN), whose experts meet at a congress, today between 7 and 10% of the population has to deal with chronic kidney disease and the trend is rising as the population ages.

Hopes from research

It must be said that, as experts point out, in this area the research is really interesting for those with kidneys that are not working at their best. For example, drugs initially developed for the treatment of diabetes will soon be used also in chronic kidney disease patients to improve their conditions while the latest frontiers of cell therapy promise to make transplants even more effective and lasting. But what are the similarities between the treatment of diabetes and that of kidney suffering, which, moreover, do you see precisely in diabetes as one of the possible “drivers”?
> What connects the two situations in terms of treatment is the use of drugs initially designed for the treatment of type 2 diabetes, SGLT-2 inhibitors (sodium-glucose cotransporter 2) which decrease blood glucose levels by increasing glucose excretion in the urine.

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Numerous recent studies have shown a clear benefit of these drugs in renal and cardiovascular protection not only in patients with type 2 diabetes, but also in non-diabetic patients with renal or cardiological pathology. Specifically, these drugs, significantly slowing down the evolution of chronic kidney disease, reduce both the risk of death from kidney causes and the risk of getting to dialysis treatment.

“This is a very important therapeutic option that allows us to add a new product to the few drugs available to slow down the often inexorable evolution of chronic kidney disease towards the terminal phase of dialysis, and to improve the cardiovascular prognosis of these patients. explains Sandro Mazzaferro, Full Professor of Nephrology at Sapienza University of Rome and Director of the UOC of Nephrology – Policlinico Umberto I in Rome. Another novelty concerns anemia, one of the main complications of chronic kidney disease: an inhibitor of prolyl hydroxylase, a drug that stimulates erythropoiesis and regulates iron metabolism, has been shown to increase hemoglobin levels in renal patients in a manner comparable to the action of epoetin alfa, the standard of care, with the advantage of being an oral therapy “.

Attention to the environment

Experts draw attention to what, thinking about the problems of the moment, has been called “green nephrology”: “nephrology has a double link with the environmental issue that we can no longer ignore.

On the one hand, climate change has a negative impact on kidney health, on the other, nephrological therapies – especially those involving dialysis – are particularly impactful from an environmental point of view. “We are victims and perpetrators at the same time. It’s time to look for solutions – comments Piergiorgio Messa, President of SIN and Director of the Complex Operational Unit of Nephrology, Dialysis and Kidney Transplantation – Milan Polyclinic and Full Professor of Nephrology at the University of Milan.

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