New Drugs: Pirfenidone a new hope in diabetic kidney disease.

Diabetic nephropathy may be slowed by several means, the standard of care is blood pressure control, prescription of drugs which reduce protein in the urine and dietary changes. However the condition is almost always progressive despite these interventions.

Pirfenidone is not a particularly new drug, it has been known as an antifibrotic agent in that it reduces the formation of the primary constituent of scar tissue. Scar tissue referred to as fibrosis at the microscopic level forms as a consequence of inflammation during the process of healing.

Diabetic kidney disease has been associated with a unique type of scarring which occurs in the portion of the kidney responsible for filtering the blood. Over time this delicate filter is destroyed by fibrosis.

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The current study found that pirfenidone when given to laboratory mice reduced the damage to their kidneys by reducing the precursors of inflammation that lead to scarring. This is exciting news as pirfenidone directly targets a pathway that was previously not directly influenced by current therapy. This would therefore be a valuable adjunctive medication to be used alongside established treatment should the drug live up to its promise.