PROteKT study findings published

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Acute kidney injury (AKI) is a sudden reduction in a person’s kidney function. Some medicines can cause a drug-induced kidney injury, and together these are the second most common cause of AKI in children. AKI is associated with increased risk of death, longer hospital stays, and long-term risk of chronic kidney disease. Researchers from the MRC Centre for Drug Safety Science at the University of Liverpool have been investigating ways to prevent drug-induced kidney injury.

One group of drugs that can cause kidney injury are a type of antibiotic called aminoglycosides. These are commonly used to treat resistant bacterial chest infections in children with cystic fibrosis (CF). Unfortunately these antibiotics can cause AKI in up to 20% of children with CF.

Today Dr McWilliam and colleagues publish the findings of the PROteKT study, a randomised controlled clinical trial in which they tested whether the kidney injury caused by an aminoglycoside called tobramycin could be prevented using a different medicine called rosuvastatin.

In this clinical trial 50 children with CF, at 13 different hospitals in the UK, were randomly allocated equally to two groups. One group received a daily dose of rosuvastatin, whilst the other group received no extra medication, during a course of treatment with tobramycin. Urine samples from these patients were checked for evidence of kidney injury by measuring increases in a biomarker called KIM-1. Overall there was no difference between the two groups in the changes in KIM-1. However, the level of kidney injury was very low in both groups, and therefore it was not possible to confirm whether rosuvastatin had a protective effect.

Dr McWilliam said ‘This study represents the culmination of a bench-to-bedside journey in which we developed and tested a novel approach to preventing drug-induced kidney injury in the lab, and were then able to test this in patients. This translational approach demonstrates the strengths of the MRC Centre for Drug Safety Science, and sets the precedent for further investigation of interventions to prevent drug-induced kidney injury.’

Click here to read the paper.

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