Chronic kidney disease (CKD) is considered to be a global health crisis. A review on this topic has been submitted to the journal, Biomaterials and Biosystems, outlining the potential of using nanomaterials for the diagnosis and treatment of diabetic kidney disease (DKD).
Study: Advancements in nanomedicines for the detection and treatment of diabetic kidney disease. Image Credit: Julia Lazebnaya/Shutterstock.com
Diabetic Kidney Disease
There are approximately 34.2 million people with diabetes within the U.S. and with this number steadily increasing, this disorder has been a focal point for innovative researchers that aim to increase the efficacy of diagnostics and therapeutics.
Diabetes can cause severe health problems such as diabetic kidney disease (DKD) as well as end-stage kidney disease. Half of the population that has been diagnosed with type 2 diabetes mellitus as well as a third of patients with type 1 diabetes diagnosis have been estimated to develop kidney disease; these health statistics demonstrate the need for advanced research in this area.
This type of diabetes associated with kidney disease highlights patients with an increased risk for further health complications such as increased aging, hypertension, and even possible early mortality.
Currently, the assessment of renal fibrosis for the indication of kidney function is carried out through a kidney biopsy, which has been the gold standard for this disorder. The use of this procedure followed by a histopathological evaluation may not be the most effective method as it is invasive and only assesses 0.01% of the tissue and therefore is not representative of results from a comprehensive insight into the entire kidney.
Diagnostic errors that occur in this procedure have led to a limited percentage of patients undergoing a biopsy. Additionally, the limitations of therapeutics for this disease are also a health concern. These aim to suppress the renin-angiotensin system for controlling hypertension; however, this can also result in hypoglycaemia and other adverse effects.
The use of nanotechnology for the advancement of theranostics has become a key driver in developing innovative approaches that can be used for overcoming limitations within current standards of practice and procedures.
Nanotechnology Research Within Diabetes
The use of nanoparticles within biomedical research has been revolutionary for developing innovative diagnostic and therapeutic approaches. This is due to the benefits of being within a nanoscale, which includes properties such as a high surface area and high reactivity and increased targetability to areas of concern.
While there has been research outlining the challenges of nanotechnology for the application of diabetes due to poor stability in vivo and inefficient targeting within the kidneys, there have also been pre-clinical studies highlighting the potential of this innovative approach.
Imaging and Drug Delivery
The current standard imaging technique for detecting DKD includes the use of CT and MRI scans; however, these require a high contrast ratio to differentiate between the structures within the body. The use of nanotechnology can be beneficial for this purpose and can be used to improve the imaging of kidneys and lead to a diagnosis of diabetic kidney disease.
Nanoparticles can be used as enhancement tools for imaging, enabling them to be an alternative to potentially toxic contrast agents that are used within the body. Gold nanoparticles have been favored within the literature for enhancing the imaging of CT scans. An example of this is anti-collagen-I antibody conjugated gold nanoparticles that have been used in mice without causing adverse side effects such as renal damage – this illustrates its benefit and potential within a clinical setting.
Gold nanoparticles can also be used as an electrochemical biosensor for detecting abnormal albumin levels, which can be indicative of early kidney damage. The use of nanotechnology in this manner can be useful as early diagnoses can result in more effective management of the disease, with targeted treatment and reduced morbidity and mortality.
While nanotechnology can be used for diagnostic applications in diabetes, it can also be used for treatments, with nanoparticles employed as drug carriers. The surface modification of nanoparticles has made this concept a promising notion for researchers that can ensure particles are precisely delivering drugs to areas of concern, such as the kidneys, for enhanced efficacy of treatments. This also ensures that healthy tissue is not being affected by the drug, which can avoid other health complications.
Nanotechnology has shown immense benefit with versatile use within a range of applications, and this has furthered their advancement for different disorders and diseases such as diabetic kidney disease.
With diabetes mellitus being a significant concern for public health, both patients and healthcare systems have been struggling to manage the health complications that can arise as a result.
The use of nanotechnology can aid in theranostics, with nanoparticles being potentially used for both diagnostic as well as therapeutic purposes. This can aid in increased efficacy in diagnoses without the use of invasive procedures such as biopsies and targeted treatments that can decrease systemic effects within patients.
Tillman, L., Tabish, T., Kamaly, N., Moss, P., El-briri, A., Thiemermann, C., Pranjol, M. and Yaqoob, M., (2022). Advancements in nanomedicines for the detection and treatment of diabetic kidney disease. Biomaterials and Biosystems, p.100047. Available at: https://www.sciencedirect.com/science/article/pii/S2666534422000095?via%3Dihub
Yamazaki, T., Mimura, I., Tanaka, T. and Nangaku, M., (2021). Treatment of Diabetic Kidney Disease: Current and Future. Diabetes & Metabolism Journal, 45(1), pp.11-26. Available at: 10.4093/dmj.2020.0217
Thomas, M., Brownlee, M., Susztak, K., Sharma, K., Jandeleit-Dahm, K., Zoungas, S., Rossing, P., Groop, P. and Cooper, M., (2015). Diabetic kidney disease. Nature Reviews Disease Primers, 1(1). Available at: 10.1038/nrdp.2015.18
Statistics, D. and Health, N., (2022). Diabetes Statistics | NIDDK. [online] National Institute of Diabetes and Digestive and Kidney Diseases.