Current Research

Because we are constantly working to improve the quality of life of our patients, research is a central part of the activities within the Division of Pediatric Nephrology.

Laboratory research is broad-based within the field and includes:

• Physiological, cell biological, and molecular investigations into the understanding of how the kidney senses and responds to acid-base disorders.
• Investigations into how carbonic anhydrase, hensin, galectin - 3 and cyclophilins influence the kidney's response to acid-base disorders.
• The role of extracellular matrix proteins regulating acid-base transport was developed at the University of Rochester Medical Center.
• Investigation into the mechanism of cyst formation and enlargement in models of autosomal recessive polycystic kidney disease.

Clinical research efforts include:

• Recruitment site and Central Biochemistry Laboratory for the NIH Funded Chronic Kidney Disease in Children Study ( CKID) - 53 sites within the United States and Canada participate in the study involving 600 children. The goal is to monitor the progression of kidney disease and its growth, cardiovascular and neurocognitive effects on children.
• Mechanisms and pathogenesis of pediatric hypertension
• Investigation of kidney tubular disorders
• Mechanisms of pediatric nephrolithiasis (kidney stones)
• Use of iohexol to measure glomerular filtration rate in kidney patients
• Successful development applications of the Schwartz Formula, a formula used internationally in estimations of glomerular filtration rate

Research Projects

George J. Schwartz, M.D.
 

Basic Science Research

• Bicarbonate Transport by the Maturing Renal Tubule (George Schwartz, PI)
  The major goals of this project are to identify hensin-dependent genes expressed by A- and B-intercalated cells of the kidney collecting duct, molecular mechanisms of adaptation to metabolic acidosis, and mechanisms for hensin’s polymerization and extracellular matrix assembly.

CKiD Research

• Central Biochemistry Laboratory of the CKiD Consortium (George Schwartz, PI)
  The long term goal is to provide accurate assays to characterize the CKiD population and maintain recruitment and retention of CKiD subjects. As the Central Biochemistry Laboratory, we provide kits, labeled tubes and cryovials, return shipping, and iohexol, and utilize the URMC Toxicology and Clinical Labs to assay iohexol concentrations, and a variety of electrolytes and analytes relevant to the assessment of kidney disease. Results are entered into the web-based Nephron database for data analysis by the Data Coordinating Center at Johns Hopkins.

GFR (Glomerular Filtration Rate) Research

George Schwartz, Sub-award Principal Investigator and Co Investigator

• Early-Stage Chronic Kidney Disease in HIV-Infected Individuals
  The purpose is to measure GFR in HIV-infected adults in Baltimore and determine the degree of kidney damage in such individuals.
• Subclinical Viral Infection and Renal Allograft Injury
  This study will determine glomerular filtration rate (GFR) in transplant patients in order to identify potential subclinical viral infections that could injure the kidney allograft.
• Residual Kidney Function in ESRD; Measurements, Serum Markers and Outcomes
  The purpose is to measure GFR in up to 200 dialysis patients during three years of this award. The subcontract to Dr. Schwartz, from Dr. T. Shafi of Johns Hopkins, is to measure iohexol concentration and calculate GFR from received serum specimens and from some urine collections.
• Improving Cardiovascular Outcomes in Adolescents to Type 2 Diabetes
  The purpose of the study is to examine GFR in Canadian youth with type 2 diabetes mellitus, specifically focusing on whether hyperfiltration is a predictor of microalbuminuria. The subcontract to Dr. Schwartz is to provide kits and measure iohexol concentration and calculate GFR from received serum specimens in 50 subjects and in 50 matched controls.
• Chronic Renal Insufficiency Cohort Study (CRIC)
  The purpose of this study is to measure GFR in children with chronic kidney disease (Stage 1-2) in order to determine if the currently developed pediatric GFR estimating equations reliably predict actual GFR in children who do not have chronic growth impairment. A second objective is to measure serum creatinine by Jaffe reaction to determine if our estimating equations from the CKiD study work comparably well for this method.
• Immune Deregulation and Kidney Disease After Hematopoietic Cell Transplant
• The Effect of Depo-Provera on HIV Susceptibility, Immune Activation, and PrEP PK Center/Coordination, Analysis and Management/MACS
• Phosphate Binders in Children with Chronic Kidney Disease-Mineral Bone Disorder
• The Interface Between Critical Acid-Base Mediators and the Renal Bacterial Defense

Marc B. Lande, M.D., M.P.H.

• Dr. Marc Lande leads our hypertension research efforts, supported by his NIH-funded study of neurocognition in primary hypertension. His focus is on target organ damage and neurocognitive and psychological correlates. In addition, Dr. Lande serves on the Neurocognitive Subcommittee for CKiD and is a site PI for CKiD.

Jeffery Michael Purkerson, Ph.D.

• Dr. Jeffrey Purkerson - Current studies are aimed to define the relative contributions of extracellular matrix proteins, hensin, and chemokine signaling pathways (e.g. SDF1/CXCL12, CXCR4) to adaptive mechanisms utilizing transgenic mouse models in which the respective ligand/receptors are selectively deleted from the collecting duct.

Erin R. Rademacher, M.D.

• Dr. Erin Rademacher initiated a pilot study to examine kidney function in former NICU patients at high risk for permanent renal disease. The work is an outgrowth of a weekly clinic where she manages acute kidney injury and other renal complications for this patient population.

Fellowship Research

View research projects of current and past fellows.