The Division of Nephrology offers diverse opportunities for basic and clinic research. Several large clinical trials are ongoing and a variety of non-clinical study activities are being pursued across the Division.
The Division of Nephrology offers a large number of opportunities in many different areas of interest for Basic Research experience. Funding for basic research in the Division of Nephrology is available from numerous sources, including the National Institute of Health (NIH), Department of Veterans Affairs, Divisional and University Research monies, corporate sponsorship, and private foundations or associations (NKF, AHA, etc.). Nephrology faculty use a variety of contemporary models and methods to investigate major areas of interest relevant to kidney disease which include:
- Renal tubular epithelial cell function
- Fundamental signal transduction mechanisms
- Renal physiology
- Oxidant biology and pathophysiology
- Progression of renal disease in animal and cell culture models
- Urine biomarkers of acute renal failure
- Glomerular Renin-Angiotensin system
- Renal Proteomics
- The role of cilia in Polycystic kidney disease
Basic research questions are also addressed by using various animal models including transgenic mice and rats, zebrafish (Nephrology runs the MUSC zebrafish facility), and occasionally other species as model systems. All of these systems are integrated with cell culture models and in vitro biochemical methodology to address questions regarding mechanisms of renal tubular and glomerular function and diseases. Techniques include micro-puncture, isolated perfused glomeruli, animal and organ hemodynamic measurements, histochemistry, patch-clamp, confocal microscopy, MALDI-TOF mass spectrometry, and various contemporary biochemical/molecular biology methods (targeted gene deletion, dominant negative cDNA transfections, generation and expression of mutant signaling molecules, protein/RNA/DNA blotting and PCR, phosphorylation assays, microphysiometry, gel proteomics, DIGE, and real-time PCR).
All of our clinical faculties have active collaborations with basic scientists from the Division of Nephrology or from other disciplines, providing further expertise in human and animal genetics, positional cloning, environmental toxicology, therapeutic ribozymes, therapeutic and experimental antisense oligonucleotides, viral vectors, confocal microscopy, fluorescent automated cell sorting, and real time analysis of transcription in living cells.
The Division of Nephrology offers diverse opportunities for clinical Investigation. Several members of the faculty are principal investigators or collaborating investigators for large clinical trials. Faculty are also involved as investigators or co-investigators for local sites for multicenter pharmaceutical sponsored phase 3 and phase 4 clinical trials. Some of the current clinical studies or clinical research projects include Biomarker Discovery in human kidney diseases.
Biomarkers are proteins that can be used to diagnose diseases, predict prognosis, or project a patient's response to therapy. A rapidly developing area of translational research is biomarker discovery. We are developing and using new proteomic and informatic technologies to identify patterns of biomarker proteins in urine that can predict diagnosis and prognosis of patients with renal diseases. An example of biomarker discovery is our recent identification of a pattern of proteins that can distinguish between patients with four glomerular diseases: FSGS, membranous nephropathy, lupus nephritis, and diabetic nephropathy. Renal glomerular diseases are a leading cause of end-stage renal disease. This discovery may lead to tests that can replace the kidney biopsy as a diagnostic technique. Using a diagnostic test instead of kidney biopsy will enable doctors to diagnose patients faster and earlier in their diseases without the need for a potentially risky procedure. We are currently working on creating an assay that can be tested clinically. We are also identifying markers that can diagnose acute kidney injury, predict whether patients with acute kidney injury will require dialysis, and predict which diabetic patients are at greatest risk of developing kidney disease. Future studies will test these markers. Identification and testing of protein biomarkers can improve treatment and prolong and improve the lives of the millions of patients with kidney disease.