Drug could treat acid issue in chronic kidney disease

A new drug could one day control metabolic acidosis, a common condition that often accompanies chronic kidney disease, researchers say.

Chronic kidney disease—which affects about 14 percent of Americans—kills more people each year than breast or prostate cancer. Patients often develop metabolic acidosis, where there is too much acid in bodily fluids because diseased kidneys are less able to remove it.

Clinicians currently treat the condition in two ways. Most commonly, they prescribe drugs like sodium bicarbonate (baking soda) that are absorbed from the gut into the blood to neutralize accumulated acid. Alternatively, clinicians prescribe a diet that limits acid accumulation in body fluids.

The new drug candidate, called veverimer, offers a way to remove accumulated acid from the gut without entering the bloodstream to treat metabolic acidosis safely and effectively, according to a phase III clinical trial detailed in The Lancet.

“In later stages of chronic kidney disease, metabolic acidosis may further complicate the condition, resulting in muscle wasting, bone loss, and further progression of kidney disease,” says Donald Wesson, professor at the Texas A&M College of Medicine and nephrologist by medical specialty.

“The importance of metabolic acidosis as both a serious complication of chronic kidney disease and an underlying cause of chronic kidney disease progression has been under recognized and markedly under treated.”

In the first long-term, randomized, multicenter, blinded, placebo-controlled clinical trial to evaluate the treatment of metabolic acidosis in patients with chronic kidney disease, veverimer proved more effective than a placebo at treating the condition.

Researchers followed patients for an initial 12 weeks, then in a 40-week extension study. In those 40 weeks, only 2 percent of people on veverimer had serious adverse events compared with 5 percent of those taking a placebo.

The next step, the researchers say, is to submit a new drug application to the US Food and Drug Administration.

“Metabolic acidosis is common, harmful, and must be treated to help spare patients the untoward consequences of chronic kidney disease,” Wesson says. “Veverimer offers the hope to treat this devastating complication safely and effectively.”

Source: Kelli Reynolds for Texas A&M University

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