About Kidney Disease

Kidneys rid wastes from the blood.  For most people, having two kidneys is more than twice what’s needed because each kidney has a large capacity to function even when some loss of filtering capacity occurs, as happens naturally with age or as the result of certain acute conditions and chronic diseases, such as infection and diabetes.  However, once renal function declines to the point where the filtering capacity of the organ is inadequate, the patient requires renal replacement therapy, in the form of dialysis or a transplant. 

Acute Kidney Injury

Over a million patients are affected by acute kidney injury (AKI) each year in the US.  AKI is a sudden loss of kidney function that may become permanent and result in death. Most occurrences of AKI occur in the hospital, where up to 40% of patients in the ICU will experience AKI.  There is no effective treatment for AKI.  One cause of AKI is the use of cardiopulmonary bypass (heart-lung machine) during open heart surgery.  Surgery patients with certain factors such as existing kidney disease, previous cardiac surgery, compromised heart function, advanced age, and diabetes are at higher risk for AKI during this type of surgery.  One new approach to treating AKI is by taking advantage of the HGF/c-Met pathway.

Renal Transplantation and Delayed Graft Function

Kidneys for transplant come from two sources:  a living donor such as a relative, and from a deceased donor.  A frequent complication that occurs after transplant of a kidney from a deceased donor is delayed graft function (DGF), where the new kidney does not function adequately to sustain the patient, requiring the patient to continue on dialysis until the new kidney gains function.  DGF is essentially acute kidney injury of the donated kidney.  While most such DGF organs gain function, it is established in the literature that the longer the post-transplant patient requires dialysis, the poorer the renal function short and long term, and the poorer the survival of the graft.  There is no effective treatment for DGF. One new approach to treating DGF is by taking advantage of the HGF/c-Met pathway.

Chronic Kidney Disease

Long-term damage to the kidney from diseases such as diabetes leads to scarring (fibrosis) and eventual organ dysfunction.  Diabetic nephropathy afflicts millions of patients. One approach to preventing the long-term damage to the kidney is to prevent fibrosis.  This may be achievable by inhibiting the function of certain proteins that activate pro-fibrotic pathways under disease conditions.  Another route to inhibiting chronic kidney disease is by inhibiting the production of aldosterone which in turn lowers blood pressure, a desirable effect not always achievable with standard blood pressure lowering medications.