Kidney Care Appeal

Research in the Lab

What we are doing about kidney disease

In the John Walls Renal Unit here in Leicester, we are doing research to tackle kidney disease in a number of ways:

  • We are researching the reasons that people get kidney disease, to try to prevent it happening in the first place
  • We are researching why early kidney problems get worse, to try to prevent people getting more and more ill
  • We are researching ways of improving the overall health and quality of life of people with advanced kidney disease, those on dialysis treatment, and those who have had a transplant.

Our research is of three main types:

  • Laboratory Research (described below) using cultured cells to discover the basic mechanisms involved in kidney disease
  • Clinical Research using blood and tissue samples from patients to study the disease processes and their response to treatment
  • Community Research aimed at discovering why some members of the community are more prone to kidney disease than others

Research on the Causes of Kidney Disease

Fluorescent image of a microscopic section of a patient’s kidney stained to show the presence of  Immunoglobulin A1

A common cause of kidney disease is that proteins from the immune system (known as Antibodies or Immunoglobulins) stick within the parts of the kidney that normally filter the blood. The reason for this is poorly understood. One particular protein which is important in this disease process is called Immunoglobulin A1. Research in this laboratory has shown that the Immunoglobulin A1 molecules in the patients are slightly abnormal when compared with Immunoglobulin A1 molecules from healthy people. How these abnormal molecules bind to kidney cells is now being investigated to find out how this leads to damage to the kidney.

More information on this research can be found on the website of the University of Leicester Department of Infection, Immunity and Inflammation staff page of Dr Jonathan Barratt

Research on Why Kidney Disease Progresses

Scanning electron microscope picture of podocytes on the surface of a microscopic blood vessel in the kidney.

An important step in the process that makes kidney disease progress is that the kidneys start to leak blood proteins into the urine. This means that blood proteins are entering parts of the kidney that they would not normally be able to reach, and it is believed that this causes further damage to the kidney.

Laboratory research here is focussing on two main areas: the specialised kidney cells called podocytes which filter blood proteins in the kidney; and a large protein molecule called Megalin which is an important site on the surface of kidney cells to which proteins bind when they have leaked from the blood.

More information on this research can be found on the website of the University of Leicester Department of infection, Immunity and Inflammation staff pages of Professor Nigel Brunskill and Dr Peter Topham

Research on Scarring of Kidney Tissue

In many forms of kidney disease, a step that often occurs late in the progress of the disease is the formation of scar tissue in the kidney. This involves accumulation of cells and proteins similar to those that accumulate in the skin following a serious wound. It has been shown that a type of cell called a macrophage, which is derived from white blood cells, infiltrates the kidney tissue and releases substances that cause scarring. New therapies are also being developed by investigating how substances called kallikrein and C-peptide (which occur naturally in the human body) may be able to prevent this scarring process.

 

Research to Improve the Health of Patients with Advanced Kidney Disease

Cultured muscle cells growing on a plastic culture dish
Research supported by
Kidney Research UK logo

Even though patients with advanced kidney disease can be kept alive by dialysis therapy (which partly replaces the function of the damaged kidneys), a problem in many patients is that they gradually lose muscle tissue, a wasting illness that eventually leads to serious deterioration in their overall health.

At this stage in their kidney disease, nearly all patients have lost the ability to excrete acid (derived from their diet) into their urine. This leads to accumulation of acid in their blood and tissues. There is evidence that this acid is a major cause of the muscle wasting problem.

Research in the laboratory using cultured muscle cells has shown that addition of small amounts of acid to the cultures has a similar wasting effect, and that the acid acts by slowing down the rate at which vital nutrients called amino acids enter the cells.

Exercise therapy for kidney patients is currently being investigated as a possible way of overcoming this muscle wasting problem, and this exercise research is described on the Research in the Clinic page.

More information on this research, and references to published work, can be found on the website of the University of Leicester Department of Infection, Immunity and Inflammation staff page of Dr Alan Bevington.

UPDATED: 4th February 2011
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