New kidney research from the University of Virginia School of Medicine has raised concerns that long-term use of heart failure and blood pressure drugs could be contributing to kidney damage.
The researchers advised that patients should continue taking the medications, such as the widely used ACE inhibitors. However, scientists are urging more studies should be performed to better understand the drugs’ long-term effects.
The findings have been published in the scientific journal JCI Insight. The research team comprised of Hirofumi Watanabe, Alexandre G. Martini, Evan A. Brown, Xiuyin Liang, Silvia Medrano, Shin Goto, Ichiei Narita, Lois J. Arend, Sequeira-Lopez and Gomez.
Drugs could induce kidney damage
Chronic high blood pressure affects a billion people around the world. The UVA researchers wanted to gain a better understanding of why severe forms of the condition are often accompanied by thickening of the arteries, and small blood vessels in the kidney, leading to organ damage.
They found that specialised kidney cells called renin cells play an important role. These cells normally produce renin, a vital hormone that helps the body regulate blood pressure. But harmful changes in the renin cells can cause the cells to invade the walls of the kidney’s blood vessels. The renin cells then trigger a build-up of another cell type, smooth muscle cells, that cause the vessels to thicken and stiffen. Resulting in the blood not flowing through the kidney as it should.
“Our studies show that renin-producing cells are responsible for the damage. We are now focusing on understanding how these cells, which are so important to defend us from drops in blood pressure and maintain our well-being, undergo such transformation and induce kidney damage,” said Maria Luisa Sequeira Lopez MD, of UVA’s Department of Pediatrics and Child Health Research Center. “What is needed is to identify what substances these cells make that lead to uncontrolled vessel growth.”
Life-saving treatment
The researchers uncovered that long-term use of drugs that inhibit the renin-angiotensin system, such as ACE inhibitors or angiotensin receptor blockers, have a similar effect. These are widely used for many purposes, including treating high blood pressure, congestive heart failure and heart attacks, as well as preventing major heart problems. Yet, the scientists found that long-term use of the drugs was associated with hardened kidney vessels in both lab mice and humans.
Additionally, the researchers noted that the medications could be life-saving for the patients; therefore, they should continue using them. However, additional studies are necessary to grasp the long-term effects on the kidneys.
“It would be important to conduct prospective, randomised controlled studies to determine the extent of functional and tissue damage in patients taking medications for blood pressure control,” said Ariel Gomez, MD, of UVA’s Department of Pediatrics and Child Health Research Center. “It is imperative to find out what molecules these cells make so that we can counteract them to prevent the damage while the hypertension is treated with the current drugs available today.”
