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  3. New Drug for Kidney Disease: FDA-Approved CKD Medication
  • Nephrologyy

New Drug for Kidney Disease: FDA-Approved CKD Medication

By Rahul Chauhan| Last Updated at: 13th Apr '24| 16 Min Read

Chronic Kidney Disorder is a condition in which the kidney's functioning degrades over time. If not treated in time, it can lead to kidney failure.


As per the National Kidney Foundation, more than 10% of the world's population suffers from chronic kidney disorder. Millions of people die annually due to not having access to proper treatment. Studies state that CKD ranks 18th among diseases for the cause of the total number of deaths per year.  


Every year, around 20 million people need a kidney transplant or dialysis treatment to live, yet less than 2 million get access to such treatments. Of these 2 million, only 20% of the patients are from developing countries.
 

It is estimated that in developing countries like India and China, the kidney failure rate will increase proportionally with the increase in the elderly population. In such countries, treating CKD becomes a financial burden, and thousands of people die due to the inability to treat kidney failure. 


From the above-given information, the severity of chronic kidney disorder (CKD) can be understood, and why the new drug for treating CKD is so essential.

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In 2021, the FDA approved Farxiga (dapagliflozin) to slow down the process of kidney degradation. Forxiga® (dapagliflozin) was added to the Australian Pharmaceutical Benefits Scheme (PBS) on September 1, 2022, with the goal of lowering the risk of progressive deterioration in kidney function in people with proteinuric chronic kidney disease who matched the PBS listing's specific requirements.

Let's take a closer look at this new treatment.

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What is the New FDA Approved Treatment for CKD?

  • Dapagliflozin is an oral drug. It aims to slow down the process of kidney degradation. It does so by absorbing glucose from the kidneys into our circulatory system.
  • Dapagliflozin is the latest drug to be added to the PBS for treating CKD in the last 20 years.
  • It is also the first medicine approved for treating CKD involving the leak of protein in the urine to many patients.
  • It is advised to take Dapagliflozin as a second-line treatment concurrently with other drugs.
     

A study shows that when dapagliflozin is added to standard treatment, people with CKD (with or without type 2 diabetes) have a lower risk of CKD development. International guidelines and KDIGOz recommend dapagliflozin as a standard treatment for CKD (with or without type 2 diabetes).

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Are there any side effects associated with Farxiga (dapagliflozin)?

Like any other medicine, this new drug has its side effects. No matter how minimal, one should be aware of the medicine's adverse effects. Below we have presented you with the side effects of this new drug, so pay attention!

  • It may cause urinary tract infections in some cases.
  • It may lower glucose levels in your body.
  • Dehydration
  • Hypotension
  • Temporarily reduced kidney functions
  • Euglycaemic ketoacidosis

Note: The chances of facing side effects are much higher among patients with type 2 diabetes than others.

What should the patients know?

  • After taking Dapagliflozin, the patient's blood pressure may drop, and they can feel dizzy. They should rest for a few hours after consuming the drug.
  • Urine tests will show the presence of glucose during the treatment period.
  • It is suggested to drink enough water to control dehydration of their body.
  • Consuming Dapagliflozin can increase the chances of genital infections. It is suggested to maintain personal hygiene and seek medical attention if needed.
  •  Dapagliflozin can be consumed pre and post-meal.
     

Who are not eligible for this new CKD treatment?

  • Patients with polycystic kidney disease
  • Patients with a recent history of immunosuppressive therapy
  • Patients with serious hepatic impairment
  • Patients less than 18 years of age
  • Patients with known hypersensitivity or allergies to any of the ingredients
  • Patients with type 1 diabetes
  • Patients with diabetic ketoacidosis
  • Women during pregnancy. Also, it is suggested to discontinue the treatment if pregnancy is detected during the treatment.
  • Women who are breastfeeding

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References:

https://www.kidney.org/

https://www.kidneycareuk.org/

https://www.fda.gov/

/first-new-treatment-in-more-than-20-years-added-to-the-pbs-for-people-living-with-proteinuric-chronic-kidney-disease.html

https://www.nps.org.au/

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Question and Answers

I have started having sharp pain in right back side so I go to the doctor and I did sonography and my sonography showed 7mm kidney stone at right kidney in upper calayx and irregular urinary bladder wall? cystitis pvr 5cc noted then doctor give me medicine I took tablets 15 days and now after two months Vomiting once and fever at night and back pain on right side and little burning urine and weakness and I go to the bams doctor and he give me calcury tab 2tab two time a day for 10 days but this time no fever or vomate only sometime right back pain and sometime burning urine. Do I go back to the Calcuri tab at the same dose?

Male | 21

Your symptoms of back pain, urine burning, and general weakness are likely due to the kidney stone. I suggest you to keep on taking Calcury tablets as the BAMS doctor prescribed you. Stay well-hydrated and eat a balanced diet. If these symptoms last or worsen, it's vital to get medical help. 

Answered on 22nd Aug '24

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Hello (apologies for long post) Caucasian, Male, 60, 6'0", 260 lbs. Meds: Lisinopril 40 mg, Metoprolol 50 mg x2 a day, Amlodipine 10 mg, Furosemide 20 mg, Glimepiride 1 mg, Janumet 50-1000 x 2, Atorvastatin 10 mg...NO drink/smoke or rec. drugs. Issue: After a lot of work, have lost 40+ lbs in last 5-6 years...blood pressure 130/85, A1c 7.0 ...here is the issue. In March of 2023, after years of my GFR staying constant in mid/upper 40's, (not great, but consistent), it was lower at 41. Dr wanted to check it again in 1 month. I very strictly controlled my diet/sugar/protein/soda/increase water intake, etc...take meds religiously...GFR dropped to 35. Dr sent me to a nephrologist, but before the scheduled appointment (which was 6 weeks later), he took me off of Triamterene...said it can be hard on kidneys. When the nephrologist sent me for labs, GFR went UP to 50. Another test 2 weeks later and GFR went up to 55. Nephrologist says that removing Triamterene from regimen played NO part in GFR rising...put me on Spironolactone due to edema returning . 6 months later at next check-up, all numbers and BP continue to be good, but GFR back down to 40. Is it possible that the diuretics have been hard on my kidneys and causing the lower GFR. I understand with years of HBP/diabetes, the GFR is not ideal, but I'd like to keep it in the 50's if possible. Family doctor took me off the Spironolactone and put me on Lasix in March of 2024...bloodwork coming up in a couple of weeks. Family doctor seems to think the diuretics have contributed to lower GFR...Nephrologist says they have nothing to do with my fluctuating GFR numbers... seeking input from anyone here with knowledge/experience...appreciate any insights re: affect of diuretics on GFR...alternatives to traditional diuretics, etc. I've read loop diuretics like Lasix best for kidney issues.

Male | 60

Answered on 22nd Aug '24

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I am 72 years.recenly kidney function test blood report I found my creatinine level is 1.61 and egfr is 43.i do not have any kidney problem as such.In 2019 I undergone angioplasty in Jupiter hospital.and that time my creatinine level was 1.6 and you had given me the medicine Reno save and the level came down

Male | 72

Your creatinine level is a bit above normal and your eGFR is a bit below normal. These are not a big deal and can occur due to age or some health problems in the past like angioplasty. It may not be visible in the beginning. Thus, living a healthy lifestyle such as eating well, drinking enough water, and making regular doctor visits can greatly assist your kidneys. 

Answered on 12th Aug '24

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Şu anda 20 yaşındayım yeni biyopsi oldum sonucuma bakarmısınızIKLAMA: 7yaşında nefrotik sendrom tanısı alan ve tedavi gören olgu, albumin düşüklüğü sebebi ile biyopsi alınma kliniği bildirilen olguya ait HE detayda, 20 adet glomerül izlenmiş olup, 2 glomerülde global skleroz izlenmiştir. Diğer glomerüller irili ufaklı çaplarda olup, Bowman aralıkları açık olarak gözlendi. Glomerüler bazal membranlarda hafif kalınlaşma bazı glomerüllerde mevcuttu. Ancak tüm glomerüllerde mezengial hücre artışı-matriks artışı gibi bulgular izlenmedi. Glomerüler alanda izlenen bulgular spesifik olarak izlenmezken,interstisyel damarlardan (orta çaplı damarlarda) bir tanesinde duvar kalınlaşması, lümen daralması gibi vasküler basınç değişiklikleri lehine yorumlanabilecek bulgular izlenmiştir. Detayda ilave olarak interstisyel fibrozis (%20-25) iken; interstisyel alanda köpüksü histiositler ve lenfoplazmositlerin de eşlik ettiği ksantogranülomatöz pyelonefrit morfolojisi izlendi.Tubuler alanda patoloji izlenmedi. Sayfa 1\ 2

Dişi | 20

Answered on 12th Aug '24

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