Satellite Dialysis Clinical Investigator Grant:
Project: Weight Trajectory and Outcomes in Kidney Disease
Elaine Ku, The Regents of the University of California San Francisco; San Francisco, CA
Obesity amongst chronic hemodialysis patients has been associated with a survival advantage compared to normal weight in a phenomenon described as the “obesity paradox.” However, obesity in children on dialysis has not been associated with a lower risk of death compared to normal weight. One of the potential reasons for these differing observations in adults versus children may be due to delivery of more aggressive nutritional interventions in children with kidney disease to maintain weight and growth. Thus, I hypothesize that one reason adults who begin dialysis with a normal weight have a higher risk of death may be due to significant weight loss that occurred prior to needing dialysis. The objectives of this proposal are to 1) characterize weight trajectory in adults versus children; 2) examine the association between weight change before dialysis and risk of death after dialysis in adults.
Young Investigator Grants:
Project: APOL1 Related Kidney Disease in Sickle Cell Disease
Divya Moodalbail, Nemours/ Alfred I. duPont Hospital for Children, Wilmington, DE
Sickle cell disease (SCD) is a chronic, debilitating, hereditary blood disorder seen in 1 in 300 African Americans, associated with multitude of acute and chronic health problems including increased risk for kidney disease, usually by mid-20s. Early identification of youth with SCD at high risk for kidney disease is critical because available preventive interventions can promote kidney health and reduce advanced kidney disease requiring dialysis or kidney transplant. The goal of the study is to identify evidence of early kidney disease in youth with SCD, and to identify presence of genetic markers associated with increased risk for kidney disease. Our goal is to test African American SCD youth for variants of apolipoprotein-1 gene known to be associated with increased risk for kidney disease. This study will enable us to test our hypothesis that SCD patients with APOL1 gene changes will have greater expression of laboratory markers of kidney disease.
Project: Toll-like Receptors Induced Pathways in Lupus Nephritis
Hanni Menn-Josephy, Boston Medical Center, Boston, MA
Lupus is an autoimmune disease that mainly affects young women of child-bearing age. It is characterized by the production of proteins that bind to DNA and RNA and form complexes. The complexes cause local inflammation in the kidney, which can result in kidney failure. Genetic variations in protein called Interferon Regulatory factor 5 (IRF5) increase the risk of developing lupus. The purpose of this study is to determine whether IRF5 plays a role in lupus-related kidney disease. We will obtain kidney samples from lupus patients with active kidney disease and measure IRF5 expression in various kidney immune cells. To determine whether the IRF5-expressing immune cells in the kidney are activated, we will compare global gene expression to resting immune cells of the same type. Overall, this project will identify whether IRF5 or other proteins in the IRF5 pathway are potential new targets for the treatment of lupus kidney disease.
Project: Sleep restriction and renal function
Ciaran McMullan, Brigham and Women's Hospital, Boston, MA
Kidney function is regulated by the sleep-wake cycle. Coordination of this periodicity in the kidney permits anticipation of the metabolic and physiological demands of the kidney throughout a 24-hour cycle. Although sleep disruption has been studied extensively in cardiovascular and metabolic disease, its association with chronic kidney disease (CKD) has not been studied. Furthermore, low levels of the “night-time” hormone, melatonin, have been associated with many conditions related to CKD, including hypertension, diabetes, and systemic inflammation, yet the benefits of increasing melatonin levels on the risk for chronic kidney disease is unknown. We aim to investigate the effect of repetitive sleep restriction and shift work on risk factors for CKD and the effect of sleep extension and melatonin supplementation on CKD risk factors among individuals at increased risk for the development of CKD.
The National Kidney Foundation gratefully acknowledges that the NKF Young Investigator Grant Program is made possible by support from (or in honor of) the following organizations and individuals:
|American Society of Nephrology
Victor Chaltiel Foundation
Shaul G. Massry, MD
Solomon Papper, MD
|Patricia Welder Robinson
Donald Seldin, MD
George Schreiner, MD
Robert Schrier, MD
Hilda Gershon Sugarman