Kidney Research Institute one of the first in U.S. dedicated solely to kidney disease research studies launched in Seattle

Today the Northwest Kidney Centers in Seattle and the University of Washington Division of Nephrology are announcing the launch of a “Patient-oriented” kidney research institute:

"Never has there been an era with so much scientific data.  But how can, how should, those data be applied to the treatment of a disease that afflicts more than 26 million Americans?” wonders Jonathan Himmelfarb, MD.

Himmelfarb arrived in Seattle last month to begin the direction of innovative research studies conducted by a new research institute, the Kidney Research Institute (KRI) – a partnership between Northwest Kidney Centers and the University of Washington Division of Nephrology. Himmelfarb hopes the results from multiple upcoming studies will translate ultimately to better care, a higher quality of life and lower mortality rates for those suffering from kidney disease.

Data have confirmed a very high rate of kidney disease in our society, and that there are a multitude of problems that kidney patients face, including an uncommonly high mortality rate,” Himmelfarb said.  “It is time to aggressively seek new approaches to identifying kidney disease early and preventing its progression, discover better predictors of kidney-disease associated risk, find new, effective treatments for advanced kidney disease through relevant research, and then translate these discoveries back into direct and improved care for the patient.”

More than twenty-seven percent of Medicare’s budget is spent on patients who have kidney disease. It is, Himmelfarb believes, an under-appreciated public health issue in our time. He is particularly concerned with the connection between kidney disease and cardiovascular disease.

Kidney patients are far more likely to die prematurely from cardiovascular-related illness rather than developing end-stage kidney disease requiring dialysis or kidney transplantation.  If end-stage kidney disease does develop, then the cardiovascular risks are further multiplied.”

Himmelfarb finds the statistic alarming: A 20-year-old with end-stage kidney disease on dialysis assumes the same cardiovascular risk of an 80 to 85-year-old without kidney disease.  Moreover, in 1972, there were an estimated 7,000 to 10,000 kidney patients on dialysis nationwide. Today, 450,000 people suffer from kidney failure.  By 2030, more than two million Americans will need dialysis, unless better preventative treatments can be found.

Therefore, many of the KRI studies will include interdisciplinary teams of physicians, scientists and others specializing in cardiology, vascular disease, nutrition and other disciplines, as well as nephrology.  Research will be conducted in conjunction with the University of Washington, Harborview Medical Center and Northwest Kidney Centers.

Active planning for several studies is already under way at the new Institute.  One study centers on improving vascular tolerance to dialysis; the second contrasts the effects of two common cardiovascular medications in patients with kidney disease.  Though studies conducted at the KRI may include pharmaceuticals or medical technology, the basis for the research must be novel.  “We are aiming to do truly fundamental studies that can make a big difference for kidney disease patients.  Accepting grants from pharmaceutical companies or the medical industry for trials or research regarding medications, for example, that are similar to those already available will not be our focus,” Himmelfarb stated.

Himmelfarb notes that a truly significant discovery that positively affected those who suffer from kidney disease was the Scribner shunt, developed in 1960 by Seattle physician Dr. Belding Scribner, allowing patients worldwide to receive lifesaving dialysis on a long-term basis.  Dr. Scribner is credited with establishing the field of outpatient dialysis.  His invention spurred the foundation of Northwest Kidney Centers, the world's first out-of-hospital dialysis program, which today thrives as one of the nation's premier treatment centers.

Currently, the KRI is located in the nephrology department at Harborview Medical Center.  When the Ninth & Jefferson medical-office building at Harborview is completed in 2009, the Institute will move into that space and will include labs and offices for physicians and researchers.

In addition to his directorship of the Kidney Research Institute, Dr. Himmelfarb has been appointed a professor in the University of Washington Department of Medicine, Division of Nephrology, and is the first holder of the Joseph W. Eschbach Endowed Chair in Kidney Research at UW.  Before coming to Seattle, Dr. Himmelfarb served as the Chief of the Maine Medical Center Nephrology Division, Director of the kidney transplant program and as Associate Chair of the Department of Medicine for research.  He serves on the editorial boards for Kidney International and the Journal of the American Society of Nephrology.  According to Dr. John Stivelman, chief medical officer at Northwest Kidney Centers, “Dr. Himmelfarb is recognized internationally for his insightful, original and timely scientific research.”

Northwest Kidney Centers has committed $3 million so far to the establishment of the KRI, to fulfill the Northwest Kidney Centers’ mission of advancing knowledge through research.  As well, in September 2007, Northwest Kidney Centers and Kirin-Amgen announced an honorary gift of $1.5 million to the University of Washington Division of Nephrology to create the Joseph W. Eschbach Endowed Chair in Kidney Research.  The gift recognizes Dr. Eschbach’s groundbreaking research in anemia, his work to improve kidney dialysis and his remarkable advancements in the field of nephrology.

This is a hugely exciting development. I have been involved in the development of the KRI and had the honor of making one of the first multi-year financial donations designated for its establishment. I expect the KRI to produce results important to people with kidney disease. This will be research independent of the kidney dialysis industrial complex of pharmaceutical and manufacturing companies. This will be research by a community owned Kidney Research Institute, an institute dedicated to the interests of people with CKD.

Welcome to Seattle Dr. Himmelfarb, the future looks brighter today.

Comments

[Patricia Woodward]

I have a question, not a comment. I believe it is possible to take a piece of another persons liver and implant it into another person that needs a liver. If my info is correct, this new liver will then grow. Is it possible to do the same thing with a kidney. Is it possible to take a piece of healthy kidney tissue and secure it to a partially damaged kidney-would this healthy tissue adhere and grow, allowing it to be more productive?

[Bill Peckham]

You're referring to a living related liver transplant - which is definitely outside of my area of expertise. However, I think I am right to say that the liver doesn't grow after transplantation, at least not in adults. I think it is a case where both parties can get by with half a liver.

In a way kidney transplant is like that - the donor gives half of their organ system in both cases. The difference being kidneys are already in halves. Once donated the kidney doesn't grow in the way you're thinking - though a donor's remaining kidney may step up to do more work then it was doing when it was one of two.

[Peter Laird, MD]

Dear Bill, just a little added note, the liver is actually one of the organs that can regenerate from even 25% to a complete liver. It makes the option of living related liver donation a little less risky compared to renal donation once the post surgical risks are overcome. Most patients will regenerate a complete liver in contrast to renal donation which reduces the total renal mass by 50%.

Here is quick reference on this interesting phenomenon.

http://www.sciencedaily.com/releases/2007/04/070411170842.htm

[Stefano Castellanos]

I live in Norway and because during some bad human service at the Haukeland Hospital I complaint, I was pulled out of the list for transplant. http://www.youtube.com/watch?v=C2RAzjZ3zzY

[liver infection]

What are the risks to others?
Some liver diseases are highly contagious and pose a risk to others. For example, different forms of hepatitis are highly contagious through sexual contact or contamination of food and water. Other liver diseases are not contagious, such as biliary atresia.

What are the treatments for the disease?
Treatment for liver disease will include:

* bed rest
* drinking extra fluids to prevent dehydration
* avoiding unnecessary medications
* avoiding alcohol
* eating a well balanced diet for liver disease
* taking antinausea medications as needed

[after liver transplant]

The liver is the most complex and metabolically active organ in the body. It performs more than 500 vital functions. Some of the important ones are:

*
It provides immunity against infection. Hence if the liver is damaged, infections are more likely.
*
It is the factory for manufacturing most of the important proteins in the body, and also cholesterol and special fat forms called lipoproteins in which all body fats are carried.
*
It clears the blood of most chemicals, drugs and alcohol.
*
It excretes bile into the intestine. Bile is vital for digestion of fats, and also serves to throw out body wastes.
*
It regulates clotting of blood by manufacturing vital proteins
*
It converts and stores extra sugar (glucose) in the form of starch (glycogen) which can be used in times of starvation.