Kidney fibrosis is a critical health problem in the United States because it represents the final common pathway of all chronic kidney diseases yet no biomarkers exist to aid in its diagnosis or measurement of progression. Using cutting edge genomic techniques, we have identified six novel biomarkers of kidney fibrosis and we hypothesize that levels of these biomarkers will accurately reflect kidney fibrosis in humans. In this proposal we have assembled three unique human patient cohorts in which to evaluate these six biomarkers, using histologic kidney fibrosis from kidney biopsy as the gold standard. We will measure biomarker levels in both serum and urine, using controlled and validated assays, and compare biomarker levels with the degree of tubulointerstitial fibrosis observed histologically. The most promising biomarkers will then be measured in a prospective chronic kidney disease cohort, comparing rapid progressors with those who do not progress. Our multidisciplinary team includes individuals with expertise in preclinical fibrosis models, assay development, molecular biology, regulatory compliance, clinical epidemiology, trial design and biostatistics. Together, the proposed experiments represent a rigorous evaluation of these six biomarkers in human chronic kidney disease and will pave the path forward for future studies that will transform clinical trial design and care in nephrology.

Public Health Relevance

Kidney fibrosis is the leading cause of kidney failure worldwide and represents an enormous health burden and unmet medical need. New biomarkers are needed to quantify kidney fibrosis non-invasively in order to identify patients at risk of kidney disease progression and to facilitate clinical trial design. We have discovered six novel biomarkers of kidney fibrosis that are extremely promising for measurement of kidney fibrosis in humans. The experiments in this application are designed to evaluate these six biomarkers in three unique patient cohorts in order to define the biomarker with the greatest promise for future large scale qualification efforts, ideally in collaboration with NIH, regulatory agencies, and industry.

Agency
National Institute of Health (NIH)
Institute
National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK)
Type
Research Project--Cooperative Agreements (U01)
Project #
3U01DK104308-02S1
Application #
9134410
Study Section
Special Emphasis Panel (ZDK1-GRB-S (O5))
Program Officer
Flessner, Michael Francis
Project Start
2014-09-24
Project End
2019-06-30
Budget Start
2015-07-01
Budget End
2016-06-30
Support Year
2
Fiscal Year
2015
Total Cost
$3,540
Indirect Cost
$1,540
Name
Brigham and Women's Hospital
Department
Type
DUNS #
030811269
City
Boston
State
MA
Country
United States
Zip Code
02115
Srivastava, Anand; Kaze, Arnaud D; McMullan, Ciaran J et al. (2018) Uric Acid and the Risks of Kidney Failure and Death in Individuals With CKD. Am J Kidney Dis 71:362-370
Malone, Andrew F; Wu, Haojia; Humphreys, Benjamin D (2018) Bringing Renal Biopsy Interpretation Into the Molecular Age With Single-Cell RNA Sequencing. Semin Nephrol 38:31-39
Srivastava, Anand; Palsson, Ragnar; Kaze, Arnaud D et al. (2018) The Prognostic Value of Histopathologic Lesions in Native Kidney Biopsy Specimens: Results from the Boston Kidney Biopsy Cohort Study. J Am Soc Nephrol 29:2213-2224
Park, Meyeon; Hsu, Chi-Yuan; Go, Alan S et al. (2017) Urine Kidney Injury Biomarkers and Risks of Cardiovascular Disease Events and All-Cause Death: The CRIC Study. Clin J Am Soc Nephrol 12:761-771
Mendu, Mallika L; Ciociolo Jr, George R; McLaughlin, Sarah R et al. (2017) A Decision-Making Algorithm for Initiation and Discontinuation of RRT in Severe AKI. Clin J Am Soc Nephrol 12:228-236
Leaf, David E; Jacob, Kirolos A; Srivastava, Anand et al. (2017) Fibroblast Growth Factor 23 Levels Associate with AKI and Death in Critical Illness. J Am Soc Nephrol 28:1877-1885
Kota, Satya K; Pernicone, Elizabeth; Leaf, David E et al. (2017) BPI Fold-Containing Family A Member 2/Parotid Secretory Protein Is an Early Biomarker of AKI. J Am Soc Nephrol 28:3473-3478
Cardenas-Gonzalez, Mariana; Srivastava, Anand; Pavkovic, Mira et al. (2017) Identification, Confirmation, and Replication of Novel Urinary MicroRNA Biomarkers in Lupus Nephritis and Diabetic Nephropathy. Clin Chem 63:1515-1526
Ó hAinmhire, Eoghainín; Humphreys, Benjamin D (2017) Fibrotic Changes Mediating Acute Kidney Injury to Chronic Kidney Disease Transition. Nephron 137:264-267
Wu, Haojia; Humphreys, Benjamin D (2017) The promise of single-cell RNA sequencing for kidney disease investigation. Kidney Int 92:1334-1342

Showing the most recent 10 out of 23 publications