A team of nephrologists and researchers at University of Miami Miller School of Medicine have discovered a factor in the blood that may be responsible for up to two-thirds of the cases of focal segmental glomerulosclerosis or FSGS. They found that an excess of serum soluble urokinase receptor (suPAR) activates a protein in the kidney podocytes called ß3 integrin. The podocytes, which serve as a filtration barrier, begin to move and allow protein to pass into the urine. The process leads to breakdown and fusing of the podocytes, impaired filtration, and glomerular scarring. The scientists found that many patients with FSGS have elevated levels of suPAR in the blood. Therapies to reduce suPAR levels or stop the suPAR-ß3 interaction could prove beneficial. Tests for suPAR levels in the blood could also identify patients at risk of developing recurring FSGS after kidney transplantation.

Source:

Nephrologists Discover Cause of Common Kidney Disease, University of Miami Miller School of Medicine, July 31, 2011

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Researchers at University of Tokyo Graduate School of Medicine have uncovered a new mechanism behind salt-sensitive hypertension. They found that a high-salt diet fed to salt-sensitive rats activates a gene called Rac1 in the kidneys; this leads to increased activity of the MR (Mineralocorticoid Receptor) protein and causes elevated blood pressure and kidney damage. Their study showed that Rac1 is regulated by both salt and aldosterone, a hormone that helps control blood pressure. They found that inhibiting Rac1 prevents high blood pressure as well as injury to the glomeruli of the kidney. Rac1 appears to be a major factor in determining salt sensitivity and could prove to be a beneficial target for preventing salt-sensitive hypertension and resultant kidney injury in humans.

Sources:

New Mechanistic Insight Into Salt-Induced High Blood Pressure, University of Tokyo Graduate School of Medicine, July 18, 2011

Abstract:

Rac1 GTPase in Rodent Kidneys Is Essential for Salt-Sensitive Hypertension Via a Mineralocorticoid Receptor-Dependent Pathway

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Researchers from Oregon Health and Science University Knight Cancer Institute have found that a gene called Src plays a role in helping some kidney cancers grow. The researchers are now looking at existing, approved drugs that may inhibit Src activity in cancer cells.  In addition, they have developed a method of identifying patients that could benefit from such drugs. This discovery could expand kidney cancer drug treatments beyond therapies that slow tumor growth, but fail to provide a cure, and don’t work for all patients.

Source:

Kidney Cancer Discovery Could Expand Treatment Options, Science Daily, July 7, 2011

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On July 1, 2011, Ronald S. Taubman, Board Member and Chair of UKRO’s Development Committee was appointed to a two-year term on the OPTN/UNOS Kidney Committee. Ron has been involved in local, state, and national organ and tissue donation and transplant issues for the last 10 years. He previously served as the Region 5 Representative on the OPTN/UNOS Pancreas Committee from July 2007 to June 2009.

Congratulations, Ron and thank you for all the work you do on behalf of UKRO and the kidney community!

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Recent stories about older living kidney donors, including some with medical issues, are truly inspiring and encouraging given the organ shortage. In an interesting article, Stephen Textor, M.D., Professor of Medicine at Mayo Clinic, describes his experience with donors with moderate essential hypertension, who would normally be excluded from donating. - Medical Abnormalities Need Not Exclude Middle-Aged Kidney Donors

In this amazing story, a 59-year-old man who once suffered from diabetes, was tested and cleared to donate a kidney to his brother. The two turned out to be identical twins, so there is no need for a lifetime of immunosuppressant drugs. – Diabetic Brothers Complete Triathlon

A 66-year-old-donor participates in a new robot-assisted transplant operation in this video report. – Robot Assists AGH Surgeon During Kidney Transplant

And here are two wonderful stories about healthy donors in their 60′s. – Tampa Nuns Say It’s a Miracle Kidney Donation Fit and Paired Kidney Donations Save Two Lives, Enrich Two Others

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Dopamine, an important neurotransmitter that helps to control the brain’s reward and pleasure centers, is often studied in connection with neurological disorders like Parkinson’s disease.  Now researchers at Vanderbilt University Medical Center have discovered that dopamine produced within the kidneys, rather than the brain, is critical to maintaining normal blood pressure and salt and water balance. They showed that mice with impaired kidney dopamine production developed hypertension and died sooner than ordinary mice, despite having normal brain and plasma dopamine levels. Although dopamine has previously been associated with hypertension, this study pinpoints the important role of dopamine made in the kidneys.

Sources:

Long Live Dopamine Production by the Kidneys, Vanderbilt University Medical Center, June 23, 2011

Intrarenal Dopamine Deficiency Leads to Hypertension and Decreased Longevity in Mice, Journal of Clinical Investigation, June 23, 2011

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Last week was an exciting one for diabetes news. In addition to our recent post about a new drug that can improve kidney function in Type 2 diabetics, there have been many other interesting discoveries.

Newcastle University researchers in England have found that a very extreme diet can reverse Type 2 diabetes in newly diagnosed patients. The diet reduced fat levels in the pancreas and liver, helping insulin production to return to normal. It isn’t known whether results will be permanent. – Type 2 Diabetes in Newly Diagnosed “Can Be Reversed”

Researchers from Massachusetts General Hospital have shown that a generic vaccine for tuberculosis that transiently reversed Type 1 diabetes in mice could work in humans as well. – Research Shows Promise in Reversing Type 1 Diabetes and Massachusetts General Hospital, Iacocca Foundation Announce Promising Results of Phase I Diabetes Trial

According to a new study, young adults with Type 1 diabetes have thicker, stiffer carotid arteries, a risk factor for heart disease. – Young People with Type 1 Diabetes at Risk for Heart Disease, Research Shows Another study found that Type 1 diabetic girls show signs of risk factors for heart disease at an early age. – Diabetic Girls May Have Heart Risk Factors

Researchers at the Karolinska Institute in Sweden have conducted two studies that may impact future treatment for diabetes. In the first study, the scientists discovered a signalling pathway that makes insulin-releasing beta cells more sensitive to high blood glucose levels. The second study found that blood levels of a lipoprotein rise prior to the onset of Type 1 diabetes. They theorize that inhibiting the lipoprotein known as ApoCIII could delay onset of the disease. – New Discoveries in Diabetes Suggest Novel Ways to Treat, Delay the Disease

Researchers from the Institute for Aging Research of Hebrew SeniorLife have identified a gene linked to having low body fat as well as an increased risk for Type 2 diabetes and heart disease. – Genetic Study Shows That Low Body Fat May Not Lower Risk for Heart Disease & Diabetes

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Results of a year-long drug trial conducted by researchers from UT Southwestern Medical Center show that the experimental drug bardoxolone methyl improves estimated glomerular filtration rates in Type 2 diabetic patients with moderate to severe CKD. Lab tests for those patients revealed decreased blood urea nitrogen, serum phosphorus, uric acid, and magnesium. The new phase 3 trial of bardoxolone is expected to be complete in 2013.

Source:

Drug Shows Improved Kidney Function for Patients with Type 2 Diabetes, UT Southwestern Researchers Report, UT Southwestern Medical Center, June 24, 2011

Bardoxolone Improves eGFR Out to One Year in Advanced CKD, By Daniel M. Keller, Ph.D., Renal and Urology News, June 24, 2011

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Researchers from UC San Diego, the National Institutes of Health, and the Mayo Clinic have shown that an experimental drug called pirfenidone can stop damage and improve kidney function in diabetic patients. Study participants treated with a small amount of the drug for one year showed improved glomerular filtration rates.

Pirfenidone, an anti-inflammatory and anti-fibrotic or anti-scarring drug, targets transforming growth factor beta (TGF-ß), a protein that contributes to kidney scarring.  Prolonged, elevated blood sugar levels lead to over-expression of TGF-ß, but pirfenidone appears to block the protein. The drug has already been used to slow the progression of FSGS and may be an option for treating other fibrotic conditions, such as pulmonary fibrosis.

Source:

Drug Effective in Treating Kidney Disease in Diabetic Patients, By Debra Kain, UC San Diego, April 21, 2011

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We’re excited to announce that UKRO will be sponsoring a rider on the 2012 Donate Life Rose Parade float. Next year’s parade theme, “Just Imagine…” pairs perfectly with the Donate Life float theme of “…One More Day,” envisioning a dream day when past moments are recaptured and new memories are made – “when donor families are reunited with loved ones, transplant recipients thrive, and living and registered donors step forward so that a life-saving transplant is available to everyone in need.”  Research undoubtedly plays a part in making “one more day” possible for kidney patients, transplant recipients, and their families, and we’re proud to be a part of this inspiring float.

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