Table 9.
Major advances by our O’Brien Center
| AKI in the ICU/Transplant Setting | |
|---|---|
| AKI Registry | Center members (Drs. Mehta, Tolwani, Cerda, Bouchard, and others) used Core A to develop a unique resource for well-phenotyped patients with AKI in a prospective multicenter, international registry of patients with AKI in the ICU. Biological samples are being collected on all patients developing AKI daily until recovery or discharge/death at UAB and UCSD sites. |
| CRRT | Center investigator Dr. Tolwani at UAB has provided new insights into the development and standardization of citrate as an anticoagulant in CRRT. This work was awarded a United States patent (US patent no. 8147698 B2) and has been licensed to Baxter worldwide. |
| Biorepository of human kidney tissues with AKI and healthy controls | Center investigator Dr. Roslyn Mannon and Dr. Michael Seifert have obtained >60 human kidney biopsies from heart beating deceased donors before implantation in addition to blood and urine samples from these donors. >65% of these biopsies display features of AKI and represent an innovative approach for obtaining human tissue to study AKI. |
| Global Snapshot of Kidney Disease in SARS-COV2 patients | Center members (Drs. Mehta, Macedo, and others) developed a new database customizing the CDC EPI-Info app for an ongoing international multicenter cohort of patients with AKI, chronic kidney disease, transplant, and end-stage kidney disease hospitalized with COVID-19 infection. This global registry will provide investigators with a unique resource for benchmarking epidemiology and outcomes of kidney disease in COVID-19. |
| Renal vascular dysfunction and hemodynamic alterations | |
| Molecular ultrasound imaging | Center investigators Drs. Hoyt, Warram, and Agarwal developed a novel ultrasound imaging technique for monitoring early inflammatory changes in AKI using P-selectin and VCAM-1 targeted microbubbles for Core B. |
| Intravital imaging | Center investigators Drs. Yoder, George, and Mrug, with the assistance of Core B, developed an intravital imaging system using an optical window to study vascular and tubular changes after AKI in live mice. |
| Computational modeling | Center investigators Dr. Vallon and Dr. Anita Layton (Duke University) are using computational modeling techniques and animal experiments to gain new insights into novel pathways in the pathogenesis of AKI and other kidney diseases (5R01DK106102, Principal Investigator: A. Layton). |
| Renal inflammation in ventilator-induced lung injury | Center investigators Dr. Singh and Dr. Crotty-Alexander at UCSD used Core B and demonstrated that ventilator-induced lung injury alters renal expression of vascular endothelial growth factor, VCAM-1, and angiopoietin-2 in sepsis models. |
| Biomarkers | |
| Neonatal AKI | Center investigator Dr. Askenazi has demonstrated the significant negative outcomes in neonates with AKI using biomarkers analyzed by Core C. He has a National Institutes of Health multicenter planning grant to study sequelae of AKI in the neonatal ICU (U34DK117435). |
| Mass spectrometry- based imaging | Center investigator Dr. Kabarowski has optimized mass spectrometry imaging in kidney sections coupled with sequential window acquisition of all theoretical spectra-lipidomics to identify the role of lipids in AKI for Core C investigators. |
| Genetic susceptibility | |
| Drug-Induced Renal Injury Consortium | Center members (Drs. Awdishu, Mehta, Tolwani, and others) studied the genetics of drug-induced AKI and identified a rare variant, rs 117992092, on the MHC class 2 region of northern Europeans that associates with vancomycin nephrotoxicity. |
AKI, acute kidney injury; ICU, intensive care unit; UAB, University of Alabama at Birmingham; UCSD, University of California-San Diego; VCAM-1, vascular cell adhesion molecule-1; MHC, major histocompatibility complex.