Probable trigger of kidney disease in diabetics identified

Researchers move one step closer to understanding the number one cause of kidney failure

Researchers identified a protein that might trigger kidney disease in diabetic patients, a condition that affects one in three people with type 1 and one in ten people with type 2 diabetes. According to a new study led by researchers at Mount Sinai School of Medicine and Thomas Jefferson University published in the February issue of PLoS Medicine, the link between this particular protein and kidney disease points to yet another reason why it is critical that diabetics keep their blood glucose levels as close to normal as possible.

Kidney disease in diabetics, known as diabetic nephropathy is the leading cause of kidney failure worldwide. It is known that this disease occurs more frequently in people from South Asia and Africa, in men, in patients whose blood sugar is poorly controlled, and in those who either have high blood pressure or smoke. However, scientists do not fully understand how diabetes damages the kidneys.

Erwin Böttinger, MD, Professor of Medicine and Pharmacology and Biological Chemistry and Katalin Susztak, MD, PhD, Adjunct Assistant Professor of Medicine at Mount Sinai School of Medicine together with their collaborator, Kumar Sharma, MD, Professor of Medicine at Thomas Jefferson University studied samples of kidneys from humans and mice with and without diabetes and looked at the effects of high glucose concentrations on the cells in the kidneys. They found that in one part of the human kidney high glucose caused a change on the surface of cells which triggered the cells to increase production of a protein called CD36. The investigators also found that some substances that are often found in the blood of people with diabetes join to CD36 and that this process triggered the death of these kidney cells. Kidney cell death is one of the first steps to occur in diabetic nephropathy.

“Our findings provide insight into one of the crucial steps in the development of diabetic nephropathy,” said Dr. Bottinger. “The role of CD36 may explain why high glucose levels are so damaging to the human kidney.”