24 March 2026
Institute news
People living with diabetes face a heightened risk of heart and kidney disease. Existing medications help protect these vital organs but have major side effects that prevent many patients from accessing their full benefits. Baker Heart and Diabetes Institute researchers have discovered that balcinrenone, a new class of heart and kidney medication, could shield vital organ function in people with type 1 diabetes while dramatically reducing the risk of these dangerous complications.
The breakthrough centres on a major barrier in current treatment — hyperkalaemia, a dangerous buildup of potassium in the blood. In research led by Professor Morag Young and Monica Kanki, balcinrenone offered comparable heart and kidney protection to traditional medications but with a critically safer profile. Published in Endocrinology, the preclinical research revealed that unlike existing treatments, balcinrenone did not suppress potassium excretion and maintained normal electrolyte balance. This suggests a safer option for patients at risk of kidney dysfunction.
Professor Young explains, “Our team used next-generation genetic analysis — RNA sequencing — of the kidney to understand why balcinrenone behaves differently. We discovered that while both balcinrenone and traditional medications like eplerenone calm the immune system's response to diabetes, eplerenone increased expression of genes responsible for potassium transport. This explains why it increases the risk of hyperkalaemia.”
Diabetes reduced expression of calcium channel genes in the heart, but both treatments modulated these levels, potentially lowering risk of arrhythmia. Balcinrenone reduced kidney damage markers more than eplerenone, suggesting better kidney protection.
Too many people with diabetes can't access the full benefit of existing therapies due to the risk of serious side effects in vital organs. These findings support balcinrenone’s potential use alongside standard anti-diabetic therapies to improve outcomes without compromising safety, offering patients better protection of their cardiac and renal function.
Balcinrenone is currently in Phase III clinical trials for heart failure, bringing this promising treatment one step closer to the patients who need it. Balcinrenone's ability to protect organs while avoiding electrolyte disturbances could transform treatment strategies for the hundreds of thousands of Australians living with diabetic complications.
