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Phosphodiesterase type 5 inhibitors and kidney disease

Baris Afsar1, Alberto Ortiz, Adrian Covic

  • 1Division of Nephrology, Department of Medicine, Konya Numune State Hospital, Konya, Turkey.

International Urology and Nephrology
|August 6, 2015
PubMed

Insights

Phosphodiesterase type 5 (PDE5) inhibitors show promise for kidney protection. A phase 2 trial found a PDE5 inhibitor reduced albuminuria in diabetic nephropathy patients, suggesting new therapeutic avenues for chronic kidney disease.

Area of Science:

  • Nephrology
  • Pharmacology
  • Cardiovascular Medicine

Background:

  • Chronic kidney disease (CKD) is a global health issue requiring novel treatments beyond standard care.
  • Current therapies for CKD, including dietary protein restriction and renin-angiotensin system blockers, are insufficient for some patients.
  • Phosphodiesterase type 5 (PDE5) inhibitors, known for treating erectile dysfunction and pulmonary hypertension, exhibit potential cardioprotective and cerebrovascular effects.

Purpose of the Study:

  • To review the potential of PDE5 inhibitors in managing kidney diseases.
  • To explore the mechanisms underlying the kidney-protective roles of PDE5 inhibitors.
  • To discuss the utility of PDE5 inhibitors in conditions like hypertension and acute/chronic kidney injury.

Main Methods:

  • Review of existing literature on PDE5 inhibitors and kidney disease.
  • Analysis of clinical trial data, including a phase 2 trial of PF-00489791.
  • Discussion of pharmacological mechanisms relevant to renal protection.

Main Results:

  • PDE5 inhibitors may offer therapeutic benefits beyond their established indications.
  • A phase 2 trial demonstrated that PF-00489791 significantly decreased albuminuria in patients with diabetic nephropathy when used adjunctively with renin-angiotensin system blockade.
  • Evidence suggests PDE5 inhibitors possess cardioprotective and cerebrovascular protective properties.

Conclusions:

  • PDE5 inhibitors represent a promising therapeutic class for kidney disease management.
  • Further research into PDE5 inhibitors could lead to novel strategies for slowing CKD progression.
  • The reduction in albuminuria observed in the trial highlights the potential of PDE5 inhibitors in diabetic nephropathy.

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