Kidney Research UK

Statement on RENAAL study

The National Kidney Research Fund welcomes the findings of the RENAAL study which are tremendously important in providing hope that the need for dialysis or a kidney transplant can be delayed or prevented in many patients with diabetes.

In recent years diabetes has emerged as one of the commonest causes of kidney failure in patients needing dialysis treatment. Insulin dependent diabetes mellitus (often referred to as IDDM or type 1 diabetes) tends to occur in children and young adults, and arises because the insulin-producing cells in the pancreas gland are destroyed. Type 2 diabetes is the commonest form of diabetes. It occurs in middle or old age because the body becomes resistant to the actions of insulin, and is unable to adequately compensate for this by an increase in insulin production in the pancreas gland. It has been recognised for some time that drugs known as angiotensin converting enzyme inhibitors can slow the progression of diabetic kidney disease in its early stage, particularly in people with type 1 diabetes. These drugs interfere with the body's renin-angiotensin system, preventing production of a key regulator of blood pressure known as angiotensin II. Angiotensin II increases blood pressure by constricting blood vessels and causing retention of salt and water by the kidneys. The RENAAL study has demonstrated that a newer agent, which interferes with the action of angiotenisn II by preventing it binding to its receptor, reduces the risk of diabetic kidney disease progressing to the point of needing dialysis in patients with type 2 diabetes who have high blood pressure.

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