A pill used for diabetes is set to revolutionise the treatment of deadly kidney disease – potentially sparing tens of thousands from dialysis and organ transplants, and saving hundreds of lives every year.
The first major breakthrough in the treatment of this condition since 20 years, 91,000 patients have been granted access by the NHS.
Following a study, which showed that daily dapagliflozin reduced the chance of dying from dialysis and transplants by 39%, this approval was granted.
At least 30,000 people need kidney dialysis – hooked up to a machine that clears waste products and excess fluid from the blood.
This can lead to three trips to the hospital each week.
The number of patients who require dialysis could be reduced by introducing a new treatment to their kidneys.
There are approximately 1,500 kidney transplants performed each year. Patients wait on average two to three years before finding a donor.
‘This drug represents an exciting new opportunity for patients,’ said Dr Graham Lipkin, a specialist and trustee of the charity Kidney Care UK. ‘It can slow the progression of the disease and we anticipate it will reduce the number of patients needing dialysis, or a transplant.’
The kidneys are two organs in the abdomen with a bean shape that filters out toxic substances and then flush them out via urine.
They each process 200 litres per day.
However, they may be permanently damaged by diabetes and high blood pressure. This reduces blood flow by constricting blood vessels which supply organs.
It permanently decreases the kidney’s ability to eliminate harmful toxins. This can lead to chronic kidney disease.
The body then becomes contaminated with toxic substances and fluids. This can lead to symptoms like extreme fatigue, chronic headaches, swelling of the face, lower back pain, and persistent headaches.
Patients are left dependent on dialysis as their kidneys gradually fail. In many cases, transplants are possible.
England is home to approximately 1.8 million cases. However, many patients remain undiagnosed.
The heart is damaged over time by kidney disease. People who are dying from this condition often experience cardiac failure.
Patients are advised to adopt lifestyle tweaks – like maintaining a healthy weight, cutting back on salt and exercising regularly.
There is no cure for high blood pressure.
The kidney disease causes damage to the heart and can lead to cardiac failure.
‘The outcome of kidney failure is not much better than cancer,’ says Dr Charlie Tomson from the charity Kidney Research UK.
‘So anything that reduces the risk of kidney failure, or patients dying from cardiovascular disease or other causes, is welcome. This drug does both of those things.’
Dapagliflozin (brand name Forxiga) is one of a number of medications that are used to remove excess glucose from diabetics’ blood. Researchers discovered that these drugs can also help improve the kidney function in people without diabetes.
NICE, a health watchdog for the public, recommended these drugs only to a small number of patients suffering from kidney disease or type 2 diabetes.
However, the New England Journal Of Medicine published the findings of a clinical study involving almost 5,000 patients. These results showed that there could be many more.
These results were so compelling that NICE decided to shorten the trial so that drug delivery could occur quickly. NICE recommends that this drug is used in combination with other medicines to maintain the kidneys’ function, such as blood pressure medication.
Mark Smith is a Harrogate-based father-of-2 aged 49 years old. His life could have been saved if dapagliflozin was available sooner. After decades of suffering from type 1 diabetes, he had a combination kidney-pancreas transplant performed in 2009. He’d been on dialysis for over three years to keep him alive.
‘A drug like this would have been a huge benefit to me – and in future it will be for tens of thousands of people,’ says Mark.
‘It could have meant I had another 15 years before needing a transplant, or I may not have needed one at all.’
Chronic kidney disease costs the NHS an estimated £1.5 billion a year – more than breast, lung, bowel and skin cancer combined.