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Amy Mottl, MD, MPH, FASN, associate professor of medicine in the Division of Nephrology, received a grant from the NIDDK to enroll adults with Chronic Kidney Disease and/or Acute Kidney Injury in a longitudinal study that includes a research kidney biopsy.

Chronic Kidney Disease (CKD) and Acute Kidney Injury (AKI) are devastating diagnoses affecting millions of Americans. Both can lead to kidney failure, requiring dialysis or kidney transplant, and are major risk factors for cardiovascular events and death. Through the Kidney Precision Medicine Project, Dr. Mottl will obtain kidney tissue from people with either CKD or AKI. The multi-year collaboration, initiated by the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) will allow investigators to better understand the conditions at a molecular level and find new treatments for CKD and AKI. Researchers will also use the biopsies to make multiple maps of kidney cells and molecular pathways important to kidney health and disease.

“We’re evolving, we’re getting new therapies, especially over the last five years or so. However, we’re still way behind in terms of our ability to really deliver precision medicine to our patients with CKD and AKI. When I say precision medicine, I mean giving the right medicine to the right patient at the right time,” Dr. Mottl, principal investigator said.

Chronic Kidney Disease

The CDC estimates over 37 million people are affected by Chronic Kidney Disease, which is when your kidneys can’t filter blood correctly. The damage happens slowly, usually over a long period of time. With the two main causes being diabetes and hypertension, conditions that have several root causes, clinicians often have difficulty giving patients a prognosis. CKD is also one of the greatest risk factors for cardiovascular disease such as heart attacks, strokes and peripheral artery disease. Only a few effective therapies are currently available for CKD.

Acute Kidney Injury

Acute Kidney Injury, the sudden decrease of kidney function, often occurs as a result of another serious medical complication. Dehydration, medications, infections and surgical complications are among the known causes of AKI. Patients can have dramatic decreases in their kidney function and sometimes require dialysis. The kidney damage is sometimes irreversible, often leading to CKD, and currently no effective therapies exist for AKI.

It can be a vicious cycle; AKI can lead to CKD and people with CKD are at much higher risk of AKI. By obtaining research kidney tissue, Dr. Mottl hopes to help find new therapies and ways to deliver precision medicine that could halt the disease process and improve outcomes for patients.

“There were no recruitment sites in the Southeastern US and this region has amongst the highest rates of CKD and end stage kidney disease. We’re also enriched for Black populations who have a significantly higher rate of CKD and end stage kidney disease,” explained Dr. Mottl. “Half of my patients, at least, have diabetes. I’m wanting to take steps to help provide new therapies and diagnostic markers for my patients.”

The five-year, $375,000 per year, U01 grant will be split between sites at the University of North Carolina and the University of Arizona. The Kidney Precision Medicine Project has the goal of discovering better preventative therapies and cures for these types of kidney diseases.

Jonathan Himmelfarb, MD, Principal Investigator for the Kidney Precision Medicine Project Central Hub will speak at Medicine Grand Rounds on February 9.