{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,25]],"date-time":"2026-09-25T09:11:44Z","timestamp":1790327504932,"version":"4.1.0"},"reference-count":32,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,9,24]],"date-time":"2026-09-24T00:00:00Z","timestamp":1790208000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100009128","name":"Research for Patient Benefit Programme","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100009128","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000274","name":"British Heart Foundation","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100000274","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Endocrinol."],"abstract":"<jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>In animal models of diabetic kidney disease (DKD), ursodeoxycholic acid (UDCA) reduces albuminuria and improves histological changes associated with DKD. The purpose of this study was to investigate the potential renoprotective role of UDCA in people with type 1 diabetes (T1D) and DKD.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>In this single-centre, double-blind, placebo-controlled crossover trial, participants with T1D and DKD with residual albuminuria (urine albumin to creatinine ratio, &amp;gt; 3 mg\/mmol) on a maximum tolerated, stable dose of renin\u2013angiotensin system (RAS) blockade with estimated glomerular filtration rate (eGFR) \u2265 30 ml\/min were included. Participants were randomly allocated to UDCA (500 mg BID) or placebo for 24 weeks, with a 4-week washout period in between. The primary endpoint was the change in urine albumin excretion rate (UAER), measured from timed urine collections after 24 weeks of treatment with UDCA compared with placebo.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Thirty-one participants were included, of whom 21 were men; the median age (interquartile range [IQR]) was 54.2 (22.7\u201375.3) years. The baseline median (IQR) UAER was 26 (12.3\u2013189.0) \u03bcg\/min for UDCA and 32.1 (19.9\u201388.2) \u03bcg\/min for placebo. The median (IQR) posttreatment UAER was 36.2 (14.9\u2013174.0) \u03bcg\/min for UDCA and 38.5 (17.6\u2013194.0) \u03bcg\/min for placebo, with no significant difference in UAER between treatments (\n                      <jats:italic>p<\/jats:italic>\n                      -value = 0.4).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>In this first-ever human study investigating the potential renoprotective effect of UDCA treatment for 24 weeks in people with T1D and DKD, we did not observe a significant reduction in UAER. Further studies are required to evaluate the role of UDCA in DKD.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Clinical trial registration<\/jats:title>\n                    <jats:p>\n                      <jats:uri>https:\/\/www.clinicaltrialsregister.eu\/ctr-search\/trial\/2015-003609-41<\/jats:uri>\n                      , identifier 2015-003609-41.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fendo.2026.1908356","type":"journal-article","created":{"date-parts":[[2026,9,25]],"date-time":"2026-09-25T08:48:23Z","timestamp":1790326103000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["The effects of ursodeoxycholic acid on albuminuria in people with type 1 diabetes and diabetic kidney disease: a proof-of-concept study"],"prefix":"10.3389","volume":"17","author":[{"given":"Nikolaos","family":"Fountoulakis","sequence":"first","affiliation":[{"name":"School of Cardiovascular and Metabolic Medicine and Sciences, King\u2019s College London","place":["London, United Kingdom"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Panagiotis","family":"Pavlou","sequence":"additional","affiliation":[{"name":"School of Cardiovascular and Metabolic Medicine and Sciences, King\u2019s College London","place":["London, United Kingdom"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luigi","family":"Gnudi","sequence":"additional","affiliation":[{"name":"School of Cardiovascular and Metabolic Medicine and Sciences, King\u2019s College London","place":["London, United Kingdom"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giuseppe","family":"Maltese","sequence":"additional","affiliation":[{"name":"School of Cardiovascular and Metabolic Medicine and Sciences, King\u2019s College London","place":["London, United Kingdom"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Angeliki","family":"Panagiotou","sequence":"additional","affiliation":[{"name":"School of Cardiovascular and Metabolic Medicine and Sciences, King\u2019s College London","place":["London, United Kingdom"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Salma","family":"Ayis","sequence":"additional","affiliation":[{"name":"School of Life Course and Population Sciences, King\u2019s College London","place":["London, United Kingdom"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fowzia","family":"Ibrahim","sequence":"additional","affiliation":[{"name":"School of Life Course and Population Sciences, King\u2019s College London","place":["London, United Kingdom"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Janaka","family":"Karalliedde","sequence":"additional","affiliation":[{"name":"School of Cardiovascular and Metabolic Medicine and Sciences, King\u2019s College London","place":["London, United Kingdom"]},{"name":"King\u2019s College London, British Heart Foundation Centre of Excellence, School of Cardiovascular and Metabolic Medicine and Sciences, King\u2019s College London","place":["London, United Kingdom"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,9,24]]},"reference":[{"key":"B1","volume-title":"Diabetic Nephropathy 2nd Edition Ed. 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