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Chronic Kidney Disease I: Introduction01:25

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Chronic Kidney Disease (CKD) arises when the kidneys progressively lose their ability to function, ultimately leading to end-stage renal disease. At this advanced stage, the kidneys can no longer filter waste or maintain essential body functions, requiring renal replacement therapy (RRT) through dialysis or a kidney transplant for survival.Early-stage chronic kidney disease and detection challengesIn CKD's early stages, symptoms often remain absent because healthy nephrons compensate for...
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Chronic Kidney Disease (CKD) progressively impairs multiple body systems due to the accumulation of uremic toxins, which disrupt cellular functions across various organs.Neurologic symptomsNeurologic symptoms often arise early in CKD, as uremic toxin buildup drives changes in cognitive and motor functions. Patients frequently experience fatigue, headache, confusion, difficulty concentrating, and, in severe cases, seizures. Peripheral neuropathy commonly manifests as burning sensations in the...
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Chronic Kidney Disease III: Interprofessional Care01:28

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Drug repurposing in kidney disease.

Usha Panchapakesan1, Carol Pollock1

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Summary

Drug repurposing offers a faster, cheaper path to new kidney disease treatments. This review explores promising candidates like glucose-lowering drugs and vasodilators for acute kidney injury and chronic kidney disease.

Keywords:
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Area of Science:

  • Nephrology
  • Pharmacology
  • Drug Discovery

Background:

  • Drug repurposing leverages existing medications for new indications, reducing costs and development time.
  • Chronic kidney disease (CKD) patients face high mortality from cardiovascular disease (CVD), necessitating integrated treatment strategies.
  • Understanding disease mechanisms aids in identifying suitable drug candidates for repurposing.

Purpose of the Study:

  • To review existing drugs with potential for repurposing in kidney diseases, including acute kidney injury (AKI) and CKD.
  • To highlight candidates addressing both renal and cardiovascular endpoints, crucial for CKD patient outcomes.
  • To focus on specific CKD subtypes: diabetic kidney disease, autosomal dominant polycystic kidney disease, and focal segmental glomerulosclerosis.

Main Methods:

  • Literature review of drugs with established safety and pharmacokinetic profiles.
  • Identification of candidates based on serendipitous findings, data mining, and mechanistic insights.
  • Inclusion of drugs targeting both renal and cardiovascular endpoints relevant to kidney disease.

Main Results:

  • Candidates for AKI include vasodilators (levosimendan) and vitamin D.
  • For CKD, promising agents include glucose-lowering drugs (SGLT2 inhibitors, GLP-1 agonists, metformin), xanthine oxidase inhibitors (allopurinol, febuxostat), and others.
  • These agents show potential for renal and cardiac protection beyond their primary indications, with some applicable to non-diabetic populations.

Conclusions:

  • Drug repurposing presents a viable strategy for developing novel kidney disease therapeutics.
  • Several drug classes, including glucose-lowering agents and vasodilators, demonstrate significant potential for treating various kidney conditions.
  • Further investigation into these repurposed drugs could lead to improved outcomes for patients with kidney disease and associated cardiovascular complications.