Abstract: FR-PO649

The Effect of Ursodiol on Kidney Function: A Retrospective Case Series of Patients with Diabetic Kidney Disease

Session Information

Category: Diabetes

  • 502 Diabetes Mellitus and Obesity: Clinical

Authors

  • Bock, Fabian, Vanderbilt University Medical Center, Nashvile, Tennessee, United States
  • Al-Dabet, Moh'd Mohanad Ahmad, Otto-von-Guericke University, Magdeburg, Germany
  • Shahzad, Khurrum, Otto-von-Guericke University, Magdeburg, Germany
  • Isermann, Berend Heinrich, Otto-von-Guericke University, Magdeburg, Germany
  • Ikizler, Talat Alp, Vanderbilt University Medical Center, Nashvile, Tennessee, United States
Background

Experimental evidence suggests that bile acids are protective in diabetic nephropathy. Ursodeoxycholic acid (UDCA, Ursodiol) has been shown to attenuate renal damage in mouse models of diabetic nephropathy in part through reducing oxidative or ER stress. Ursodiol is in clinical use for the prevention of gall stone disease and in primary biliary cirrhosis (PBC) but clinical data on the effect on kidney function in patients with diabetic kidney disease (DKD) are lacking

Methods

We retrospectively screened Synthetic Derivative, a de-identified copy of over 2 million patient records at Vanderbilt University Medical Center for the following inclusion criteria: ICD9/10 code of diabetes with diabetic nephropathy, diabetic kidney disease or renal manifestation (diagnosed between 2000 and 2008), Ursodiol started for any indication (between 2010 and 2014) and serial eGFR assessments thereafter. Repeated measures ANOVA was used to examine the effect of Ursodiol on kidney function overtime.

Results

A total of 13 patients met the inclusion criteria. At inclusion, median age was 55 (30-72) years. The majority of cases was white (10/13) had hypertension (12/13) and were on ACEi or ARB (12/13) therapy. Gender distribution was equal. Five, one, five, two and zero patients had CKD Stage 1, 2, 3, 4, and 5, respectively. Median diabetes duration was 12 years, the median Ursodiol treatment duration was 1.25 (0.5-10) years and indications for Ursodiol included: gallstone prevention post bariatric surgery, cryptogenic cirrhosis or primary biliary cirrhosis. At 12 months after initiation of Ursodiol, 92% (12/13) patients had increased eGFR (p=0.02, compared to baseline). The mean eGFR (±SD) increase from baseline was 13.5 ± 18.4 ml/min/m2 (median: 8.5 and 25-75 percentiles: 4.7-13.5).

Conclusion

This retrospective analysis showed a significant improvement in kidney function at 12 months after starting the bile acid Ursodiol in patients with diabetic kidney disease. While the results are limited by a small case number, the heterogeneity of clinical indications for Ursodiol and the number of potential confounding factors, there is precedent for prospective studies examining the use of Ursodiol as a potential treatment for amelioration of CKD progression in patients with DKD.

Funding

  • Other NIH Support