Antifungal Drug May Be New Treatment For Chronic Kidney Disease

April 01, 1997

A common antifungal drug may buy precious time for people with three chronic kidney diseases, delaying their need for dialysis or transplantation, a Johns Hopkins study shows.

The drug, which may promote healing of kidney damage by reducing overproduction of the body's main steroid hormone, could substantially reduce the risk, cost and inconvenience associated with dialysis and transplantation, says Mackenzie Walser, M.D., lead author and a professor of pharmacology, molecular sciences and medicine.

"Our findings are early but promising, and point to a new, long-term approach that may be safe and effective for treating these three types of chronic kidney disease," says Walser, adding that further studies are needed.

Results of the study, supported by the National Institutes of Health and Janssen Pharmaceutica, are published in the April issue of the American Journal of Kidney Diseases.

Researchers studied 20 patients who had one of four types of chronic kidney diseases: glomerular disease, interstitial nephritis, diabetic nephropathy or polycystic disease. The patients were treated with a well-known antifungal drug called ketoconazole for one to four years.

The treatment slowed disease progression by 66 percent in patients with glomerular disease, 55 percent in those with interstitial nephritis and 77 percent in those with diabetic nephropathy. However, the disease rate accelerated by 99 percent in patients with polycystic kidney disease.

In two patients, the treatment continued to slow progression of glomerular disease for four years. Ketoconazole caused some side effects, primarily liver problems, that often occur when it is used to treat fungus infections. Treatment was stopped in three patients because of side effects, and the patients recovered quickly.

Ten years ago, Walser and his Hopkins colleagues found that chronic kidney diseases progressed fastest in patients whose adrenal glands produced a large amount of cortisol, the body's principal steroid hormone, and slowest in patients whose adrenal glands produced little cortisol. They speculated that reducing production of cortisol might slow the progression of kidney failure by promoting the healing of injury to the kidneys. Researchers selected ketoconazole for the study because it has been shown to partially suppress cortisol production. Cortisol belongs to a group of hormones that control the body's use of nutrients and the excretion of salts and water in the urine.

The study's co-author was Sylvia Hill, B.S.

--JHMI--

Media contact: John Cramer (410) 955-1534
E-mail: jcramer@welchlink.welch.jhu.edu




Johns Hopkins Medical Institutions' news releases are available on a PRE-EMBARGOED basis on EurekAlert at http://www.eurekalert.org and from the Office of Communications and Public Affairs' direct e-mail news release service. To enroll, call 410-955-4288 or send e-mail to bpalevic@welchlink.welch.jhu.edu or 76520.560@compuserve.com.

On a POST-EMBARGOED basis find them at http://hopkins.med.jhu.edu, http://infonet.welch.jhu.edu/news/news_releases, Newswise at http://www.ari.net/newswise or on CompuServe in the SciNews-MedNews library of the Journalism Forum under file extension ".JHM", Quadnet at http://www.quad-net.com or ScienceDaily at http://www.sciencedaily.com.

Johns Hopkins Medicine

Related Dialysis Articles from Brightsurf:

Immediate dialysis no better than wait-until-necessary approach, researchers find
In the largest international study of its kind, researchers at the University of Alberta and Toronto's St.

Predictors of 5-year mortality in young dialysis patients
The analysis published in NDT [1] evaluated for the first time the association of a large number of demographic, HD treatment and laboratory variables with mortality in patients on chronic hemodialysis treatment since childhood.

COVID-19 mortality alarmingly high in dialysis patients
Analysis of a Spanish experience shows that COVID-19 is frequent in hemodialysis patients, who appear to be at risk for worse outcome.

Survival following switch from urgent in-center hemodialysis to home dialysis
Few patients who start urgent and unplanned dialysis in clinical centers switch to home dialysis.

Is ownership of dialysis facilities associated with access to kidney transplants?
An analysis that included data for nearly 1.5 million patients with end-stage kidney disease looked at whether ownership of dialysis facilities was associated with patients' access to kidney transplants.

At-home dialysis improves quality of life
The rate of people starting voluntary at-home peritoneal dialysis rose from 15% to 34% over 10 years at Kaiser Permanente in Northern California, providing a convenient and safe way to manage advanced-stage kidney disease compared with center-based hemodialysis, according to research published today in JAMA Internal Medicine.

Hydration sensor could improve dialysis
Researchers from MIT and Massachusetts General Hospital have now developed a portable sensor that can accurately measure patients' hydration levels using a technique known as nuclear magnetic resonance (NMR) relaxometry.

Uncovering possible role of polyphosphate in dialysis-related amyloidosis
Researchers from Osaka University found that the low concentrations of the naturally occurring biopolymer, polyphosphate (polyP), induces amyloid formation from β2 microglobulin under both acidic and neutral conditions but by different mechanisms.

Study compares dialysis reimbursement around the globe
Dialysis reimbursement policies in most countries are focused on conventional in-center hemodialysis, although home hemodialysis and peritoneal dialysis might contribute to quality of life and cost savings.

Elderly patients on dialysis have a high risk of dementia
Older kidney disease patients who are sick enough to require the blood-filtering treatment known as dialysis are at high risk of dementia, including Alzheimer's disease, according to a study led by scientists at Johns Hopkins Bloomberg School of Public Health.

Read More: Dialysis News and Dialysis Current Events
Brightsurf.com is a participant in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for sites to earn advertising fees by advertising and linking to Amazon.com.