While the cause of diabetes remains a mystery, doctors in New York could be a step closer to understanding one of the complications of diabetes: kidney failure.
Researchers looked at patients with and without diabetes and found at least one way that diabetes causes destruction of on the renal system.
When Fred Stiftel was diagnosed with diabetes 25-years ago, he didn’t really notice a drastic change in his health. But since, the disease has silently damaged his organs. “Diabetes has had a rather major impact on my kidneys,” says Fred.
Of the approximately 18 million people in the U.S. with diabetes, one in three with type 1 and one in ten with type 2 diabetes will develop kidney disease.
“Once you have diabetes and kidney disease, you will very likely develop kidney failure which will require you to be on dialysis, or receive kidney transplantation,” says Dr. Erwin Bottinger of the Mt. Sinai School of Medicine.
Researchers at Mt. Sinai believe they now know one way diabetes progresses to kidney disease. The key is a protein called CD36 on the surface of kidney cells, which is triggered by high sugar levels in the patient. The higher the sugar level, the more the protein.
“It is through this protein on the cell surface that the cells are instructed to undergo cell death,” says Dr. Bottinger.
And cell death leads to kidney failure.
The discovery can immediately be applied to the treatment of the disease. “We hope that by controlling blood sugar as well as we can, the presence of the molecule on the kidney cells can be lowered, resulting in less destruction of kidney cells,” Dr. Bottinger states.
Like in so many areas of medicine, research into so-called markers for disease or disease progression can be critical. CD36 is likely to be used as a tool for prevention to help doctors watch a patient’s disease.
Diabetes expert Joseph Vassalotti says, “Diabetes and kidney disease is another piece of the puzzle and I think we have a long way to go to understanding diabetes.
We are far from finding a cure for diabetes, far from achieving perfect blood sugar in everyone. In the meantime, it’s so important to do what we can to block the complications from destroying tissues and organs so important for survival,” informs Dr. Bottinger.
Such a discovery could help patients like Fred save their kidneys. As with any scientific discovery, it could be several years before this work translates into a test for the patient. At the very least, based on the connections shown to exist between diabetes and kidney failure, doctors should make sure their patients are keeping a close eye on their sugar intake.
