A novel treatment for chronic kidney disease

A gradually decreasing kidney function is seen in relation to diabetic kidney disorder, and diabetes is the most frequent cause of decreasing kidney function with a need for dialysis or kidney transplantation. Diabetes comprises an increasing part of the population (230,000 Danes in 2012), and there is a noticeable need for the development of new methods for treating diabetic kidney disorder.

Shockwaves are a new and gentle form of treatment, which has proved to restore the function of different organs and tissue. In a test with pigs, it has been proven that shockwaves may improve kidney function after oxygen deficiency in kidneys. Previously, we have conducted treatment with shockwaves for mice with diabetes, which lead to the development of new blood vessels within the kidney. The same positive effects of shockwaves has been proven in relation to other chronic diseases – including ischaemic heart disorder, diabetic foot ulcers and impotence for men.

AIM

The aim of the PhD project was to examine whether treatment with shockwaves can be used as a new form of treatment in diabetic kidney disorders. It marks the first time that shockwave therapy was tested for humans for treatment of chronic kidney disorder. In the long term, the hope is to prevent or delay decreasing kidney function and the need for dialysis in patients with diabetes.

The project aimed to treat 30 patients with moderately reduced kidney function as a consequence of diabetes. The treatments should be carried out twice a week for three weeks (six treatments in total). Both kidneys should be treated with shockwaves, and each treatment should take approximately 40 minutes. The treatment happens while the patient is lying in a bed, and under the bed is a therapy head that forms the shockwaves. The project wanted to ensure that the shockwaves were focused on the kidney through ultrasound scannning.

RESULTS

The project’s clinical trials examined adverse reactions and safety as well as changes in renal function following LI-ESWT treatment in 28 patients with diabetic kidney disease.

Patients were treated with LI-ESWT six times over three weeks and were then followed for six months after the last treatment.

The study showed that LI-ESWT is safe and only associated with few and mild side effects in patients with diabetic kidney disease. Measurements of the kidneys six months after the last treatment indicated that kidney function did not worsen in the patients after LI-ESWT, but did not give a clear answer as to whether or not LI-ESWT has the desired therapeutic effect in terms of stopping or even improving the development of diabetic kidney disease.

Based on the positive indications of the study, the research group suggests that more research be done in the field, for example through a randomised, placebo-controlled clinical trial.

PARTNERS

The project was a PhD project by Sune Møller Skov-Jeppesen. The PhD project was defended virtually on 17 December 2020.