Nav: Home

PERL concludes reduced uric acid has no impact on kidney disease in type 1 diabetes

November 08, 2019

BOSTON - (November 8, 2019) - Diabetic kidney disease (DKD) remains one of the most intractable complications of diabetes. Progress has been made using glycemic and blood pressure control, but the search continues for improved treatments for the estimated one in four adults with diabetes who has some level of nephropathy and continues at risk for eventual kidney failure.

Observational studies have shown that higher serum uric acid (SUA) is associated with a higher risk of DKD in type 1 diabetes. This held out the possibility that reducing blood levels of uric acid might prevent or slow the progression of the disease.

The Preventing Early Renal Loss in Diabetes (PERL) study was established in 2013 as a 16-site, multinational (US, Canada, and Denmark), randomized, placebo-controlled clinical trial to test whether sustained reductions of SUA would benefit patients' kidney health. The conclusions of the study were announced today at the annual meeting of the American Society of Nephrology: three years of sustained reductions of blood levels of uric acid with the generic drug allopurinol did not benefit type 1 diabetes patients with mild to moderate kidney disease.

"On the one hand, we are disappointed because we don't have something new to offer to people with type 1 diabetes who are at risk for kidney problems," says Alessandro Doria, MD, PhD, MPH, Senior Investigator in the Section on Genetics and Epidemiology at Joslin Diabetes Center, Professor of Medicine at Harvard Medical School, and co-principal investigator of the study with S. Michael Mauer, MD, University of Minnesota Medical School. "On the other hand, we are quite satisfied by the fact that we have provided a clear, unambiguous answer to an important scientific question."

While the initial hypothesis was disproved, this study focused on a limited subset of the diabetes community. "We cannot exclude that in people with type 2 diabetes or with different stages of kidney disease, there might be an effect," says Doria.

The research team plans to continue monitoring the PERL cohort, both to assess the possibility of delayed effects of allopurinol on the group and to gather more data on the development of diabetic kidney disease over time and on the risk factors.

"We have an amazing biobank of samples that we collected during the study," says Doria. "And one can correlate biomarkers measured in those samples with long-term health outcomes. The longer the follow-up, the more power there is in the study because we'd have a longer snapshot of the trajectory of declining kidney function in these people."
-end-
The PERL study was funded by grants from National Institutes of Health and JDRF.

Other institutions involved in the study included the University of Minnesota (Minneapolis), University of Colorado (Denver), University of Michigan (Ann Arbor), University of Toronto (Toronto), Northwestern University (Chicago), Albert Einstein College of Medicine (New York), Steno Diabetes Center (Copenhagen, Denmark), University of Washington (Seattle), University of Calgary (Calgary), University of Alberta (Edmonton), Emory University (Atlanta), Washington University (St. Louis), University of Texas Southwestern (Dallas), Providence Medical Research Center (Spokane), BC Diabetes (Vancouver).

About Joslin Diabetes Center

Joslin Diabetes Center is world-renowned for its deep expertise in diabetes treatment and research. Joslin is dedicated to finding a cure for diabetes and ensuring that people with diabetes live long, healthy lives.  We develop and disseminate innovative patient therapies and scientific discoveries throughout the world. Joslin is an independent, non-profit institution affiliated with Harvard Medical School, and one of only 16 NIH-designated Diabetes Research Centers in the U.S.

For more information, visit http://www.joslin.org or follow @joslindiabetes One Joslin Place, Boston, MA 617-309-2400

Joslin Diabetes Center

Related Diabetes Articles:

Tele-diabetes to manage new-onset diabetes during COVID-19 pandemic
Two new case studies highlight the use of tele-diabetes to manage new-onset type 1 diabetes in an adult and an infant during the COVID-19 pandemic.
Genetic profile may predict type 2 diabetes risk among women with gestational diabetes
Women who go on to develop type 2 diabetes after having gestational, or pregnancy-related, diabetes are more likely to have particular genetic profiles, suggests an analysis by researchers at the National Institutes of Health and other institutions.
Maternal gestational diabetes linked to diabetes in children
Children and youth of mothers who had gestational diabetes during pregnancy are at increased risk of diabetes themselves, according to new research published in CMAJ (Canadian Medical Association Journal).
Two diabetes medications don't slow progression of type 2 diabetes in youth
In youth with impaired glucose tolerance or recent-onset type 2 diabetes, neither initial treatment with long-acting insulin followed by the drug metformin, nor metformin alone preserved the body's ability to make insulin, according to results published online June 25 in Diabetes Care.
People with diabetes visit the dentist less frequently despite link between diabetes, oral health
Adults with diabetes are less likely to visit the dentist than people with prediabetes or without diabetes, finds a new study led by researchers at NYU Rory Meyers College of Nursing and East Carolina University's Brody School of Medicine.
Diabetes, but not diabetes drug, linked to poor pregnancy outcomes
New research indicates that pregnant women with pre-gestational diabetes who take metformin are at a higher risk for adverse pregnancy outcomes -- such as major birth defects and pregnancy loss -- than the general population, but their increased risk is not due to metformin but diabetes.
New oral diabetes drug shows promise in phase 3 trial for patients with type 1 diabetes
A University of Colorado Anschutz Medical Campus study finds sotagliflozin helps control glucose and reduces the need for insulin in patients with type 1 diabetes.
Can continuous glucose monitoring improve diabetes control in patients with type 1 diabetes who inject insulin
Two studies in the Jan. 24/31 issue of JAMA find that use of a sensor implanted under the skin that continuously monitors glucose levels resulted in improved levels in patients with type 1 diabetes who inject insulin multiple times a day, compared to conventional treatment.
Complications of type 2 diabetes affect quality of life, care can lead to diabetes burnout
T2D Lifestyle, a national survey by Health Union of more than 400 individuals experiencing type 2 diabetes (T2D), reveals that patients not only struggle with commonly understood complications, but also numerous lesser known ones that people do not associate with diabetes.
A better way to predict diabetes
An international team of researchers has discovered a simple, accurate new way to predict which women with gestational diabetes will develop type 2 diabetes after delivery.
More Diabetes News and Diabetes Current Events

Trending Science News

Current Coronavirus (COVID-19) News

Top Science Podcasts

We have hand picked the top science podcasts of 2020.
Now Playing: TED Radio Hour

Climate Mindset
In the past few months, human beings have come together to fight a global threat. This hour, TED speakers explore how our response can be the catalyst to fight another global crisis: climate change. Guests include political strategist Tom Rivett-Carnac, diplomat Christiana Figueres, climate justice activist Xiye Bastida, and writer, illustrator, and artist Oliver Jeffers.
Now Playing: Science for the People

#562 Superbug to Bedside
By now we're all good and scared about antibiotic resistance, one of the many things coming to get us all. But there's good news, sort of. News antibiotics are coming out! How do they get tested? What does that kind of a trial look like and how does it happen? Host Bethany Brookeshire talks with Matt McCarthy, author of "Superbugs: The Race to Stop an Epidemic", about the ins and outs of testing a new antibiotic in the hospital.
Now Playing: Radiolab

Speedy Beet
There are few musical moments more well-worn than the first four notes of Beethoven's Fifth Symphony. But in this short, we find out that Beethoven might have made a last-ditch effort to keep his music from ever feeling familiar, to keep pushing his listeners to a kind of psychological limit. Big thanks to our Brooklyn Philharmonic musicians: Deborah Buck and Suzy Perelman on violin, Arash Amini on cello, and Ah Ling Neu on viola. And check out The First Four Notes, Matthew Guerrieri's book on Beethoven's Fifth. Support Radiolab today at Radiolab.org/donate.