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Kidney Disease

Kidney Disease

Kidney Disease

Description
 Chronic kidney disease (CKD) is a progressive condition in which the kidneys are unable to function effectively. CKD is most commonly caused by diabetes. It can also be caused by high blood pressure. People who have both diabetes and high blood pressure are especially at risk. If you have CKD, your kidneys may be unable to control blood pressure or rid the body of waste through urination. Most of the time, CKD also reduces the production of red blood cells. This condition is called anemia and can cause such symptoms as fatigue, dizziness, and shortness of breath.

Who is at Risk?
 There are several key risk factors for CKD. These include: diabetes, high blood pressure, a family history of chronic kidney disease, older age, and ethnicity. Chronic kidney disease is more common in African Americans, Hispanic Americans, Asians, Pacific Islanders, and American Indians.

Source: Ortho Biotech Products, L.P.

Detecting the Genes that Contribute to Transplant Rejection
 A group of physicians and scientists led by TSRI Associate Professor Daniel Salomon, M.D. has been awarded a new federal research grant of more than $12 million over five years to apply cutting-edge genomic technologies to advance our understanding of kidney transplantation. Salomon and his colleagues will monitor several hundred patients who have had kidney transplant surgeries with technologies for gene expression profiling and proteomics, and several thousand transplant patients by complex trait genetics. One of the team"s overall goals is to answer one of the most pressing problems in kidney transplantation: why do some patients do well after a transplant while others do not? The research will involve advancing our understanding of what causes acute and chronic kidney injury. Kidney dysfunction is common to many different disease states, including diabetes and hypertension, which can damage the tiny blood vessels within the kidneys. Several genetic and autoimmune diseases as well as bacterial and viral infections and environmental toxins can also cause damage to the kidneys. Severe damage can lead to kidney failure. With a kidney transplant operation, there is a danger of transplant rejection with the "allograft" or transplanted tissue taken from another person, arising from the fact that a donated kidney is foreign to the transplant patient"s body. Left alone, the person"s immune system will detect the foreign tissue, mount an immune response and attack it - acutely "rejecting" or killing the new tissue, leaving the patient no better off than before the transplant.

Wishing to avoid transplant rejection, doctors treat patients who have had kidney transplantations with a powerful class of drugs known as immunosuppressants, which weaken the immune response and mitigate the danger. With immunosuppressants, a transplanted kidney can survive and function well for years. However, immunosuppressants also have a dark side. Immunosuppressive drugs make transplant patients more likely to suffer heart disease, diabetes, infections and cancer. These drugs are also toxic, and they can slowly poison the very kidney they are protecting. They can also cause hypertension and hyperlipidemia, eventually leading to the failure of the new kidney transplant - a condition known as chronic allograft nephropathy. Because of all the drug toxicities, one of the major challenges in treatment following the transplant surgery is to determine the proper regimen of drugs for a patient. Salomon and his colleagues would like to use the discoveries of genomic science to build a new set of tools so that doctors can measure and predict how a patient will respond to immunosuppressive drugs. With such tools, transplant doctors could monitor patients regularly to make sure their treatment is always optimal and improve the safety of therapies for organ and cell transplantation. The genetics of the patient receiving the kidney determines the character of the immune response, but it"s the genetics of the donor that determines the impact of the transplantation. The researchers are hoping to come out with an understanding of what makes a good donor, and what is it about the donor organ that determines the long-term outcome of the transplant. Such a tool may also be useful for the development of a new generation of post-transplant drugs to treat patients or to protect the kidneys of patients with early kidney disease that still have good function.

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