Transcription:
Catalysing Discoveries to Treat Kidney Disease

Melanie Cole (Host): Hello. Today we're examining catalyzing discoveries to treat kidney disease, and my guest is Dr. Susan Quaggin. She's the Chief of Nephrology and Hypertension at Northwestern Medicine, and the Director of the Feinberg Cardiovascular and Renal Research Institute. Dr. Quaggin, tell us about the current state of kidney disease today. What's the prevalence and economic and societal impact? What's different now about what we know about the disease as well?

Dr. Susan Quaggin, MD (Guest): Great question. So, kidney disease is incredibly common. That's more common than most people realize. So, in the US alone, there are more than forty million people living with kidney disease, and if we think about it globally, that increases to more than 850 million people. And a lot of people don't know they have kidney disease, and it comes along with a lot of significant risks and even significant increased risk of mortality.

On the financial side, incredibly expensive. Here in the US alone, it takes up - for end stage kidney disease - 7% of the entire Medicare budget, and that's to treat approximately 650,000 individuals. So incredibly expensive. So, over the past several decades, I would say new treatments for kidney disease have been slow to emerge, however I'm an optimist and I feel we're at a tipping point.

So, over the past couple of decades, there's been incredible discoveries about the molecules, the pathways that cause kidney disease, and if you put that together with all the new tools and technology we have to design new treatment, I think you're going to see an incredible impact in the lives of patients with kidney disease, and we're really - as I say - at a tipping point.

Host: Wow, that's really incredible, and I'm sure people don't realize the prevalence of kidney disease.

Dr. Quaggin: No.

Host: And before we talk about your research, tell us why it's that so many people don't realize they have kidney disease until it shows symptoms.

Dr. Quaggin: Right. So, unlike a lot of other disease, or even common illnesses like a cold or the flu, you can have significant kidney disease without having any symptoms, or they might be very subtle symptoms. So, it's absolutely imperative that you get your kidneys checked by your primary care physician, your family doctor, to look for early signs of kidney disease. This is simple things. It can be your blood pressure, checking your blood glucose, and also checking your urine. So very simple ways to help prevent the progression of kidney disease and to identify it early.

Host: Now let's talk about some of your fascinating research. Tell us about the prestigious National Institute of Diabetes and Digestive and Kidney Diseases Grant your team received, and tell us what this means for people, and how it's going to translate this research into prevention and treatment of kidney disease.

Dr. Quaggin: Right. So, thanks. Yeah, we are very excited about this grant. It, as you mentioned, comes from the National Institute of Health, and there are eight O'Brien Kidney Centers across the US, and we were very lucky to receive one of them. Each of these centers focuses on a different theme, it might be a specific disease. Here at Northwestern, our center has an audacious goal.

So, the mission of the center is to catalyze discovery and development of new therapies and approaches to treat patients with all forms of kidney disease. So, this can include everything from developing better tests - like we just talked about - to diagnose kidney disease earlier, more precisely, as well as to develop new approaches to prevent, treat, and ultimately cure kidney disease.

So, you might ask how are we going to operationalize this? And what we've done here at Northwestern was to exploit, or to leverage some of the unique and incredibly rich resources that's been at both campuses. So, not only at the medical school, but also at the basic science campus. So, it's very much a partnership with the Chemistry of Life processes with chemists, with nanomedicine, scientists, with scientists who bring all sorts of different expertise. We're bringing all of these individuals together with physicians, with nurses, with patients to tackle this common problem of kidney disease, really to have some of those eureka moments, and to come up with some new treatments and new therapies.

Host: It must be very rewarding to unite investigators across so many cores and the value of that cross-collaboration in your work. Tell us a little bit more specifically about some of the research that you're doing, and how that cross-collaboration is working so well.

Dr. Quaggin: Right. So, I think you're right. I think the cross-collaboration is absolutely essential if we're going to move the needle on treatments for kidney disease. It's also incredibly fun. So, bringing people together who may never even have heard about kidney disease, but brilliant scientists who have different ways to tackle problems of developing new treatments, new ways to target specific cell types. Bringing everybody together in a single room and talking about specific kidney diseases. So, it can be diseases such as kidney disease associated with diabetes or high glucose. It can be glomerular diseases, it can also be high blood pressure.

So, the way that we have structured this center, it provides a series or a group of core services that focus on developing better disease models. There's also bio-bank, which is tissue and samples from patients with kidney disease that other investigators might get access to, as well as the rich services associated with the chemistry department here at Northwestern to develop new screens, to identify new drugs, to identify or develop new approaches such as nanoparticles to treat kidney disease.

So, in order to actually make this work requires a team of dedicated individuals - so, across all spectrums of all disciplines - as well as a web portal; the www.nephroHUB.org. So that allows investigators at Northwestern, but also outside Northwestern in the US, even internationally, to come to this center, to see and to utilize some of the resources that are here, as well as to get the expertise of a variety of different individuals.

Ultimately, we want this www.nephroHUB.org to be a one-stop-shop, a place where patients can also come. Ultimately, we'll be able to see about new clinical trials, new advances in kidney disease, as well as to provide some educational and outreach to the community. So, we'll have lots of collaboration and we see this as a real team effort here at Northwestern, but also collaborating with other institutions around the Chicagoland area. We've got a very talented Chicagoland advisory board, as well as an external advisory board from individuals throughout the US and also internationally.

Host: It's really tremendous to hear you speak about it like this. How do you aim to bring these discoveries to patients, Dr. Quaggin? And tell us a little bit of what you see as a blueprint for some of this future research. Are you seeing gene therapy? Immunotherapy to help if there's already damage to kidneys? What do you see happening?

Dr. Quaggin: Right. So, those are all great questions, and I think to bring it to patients and clearly that is absolutely the ultimate goal. We hope to have patients visit the web portal frequently to see what's going on. We do have a patient advocate and a patient member on our external advisory board. Ultimately when you're a researcher or scientist, you do need to be an optimist and it requires perseverance, and requires being in it for the long-term. But I do see that new treatments are developing at a much more rapid pace.

So, you asked about things such as gene therapy, immunotherapy. Those things are absolutely possible now, and when I was training or even a few years ago, I never thought we would be talking about gene therapy to treat patients with kidney disease. To give you an example of that, at the recent Kidney Week meeting in November in San Diego, there were presentations from a group that works on glomerular disease known as focal segmental glomerulosclerosis, or FSGS. Very long name. I think nephrologists like long names. But they were talking about using gene therapy to fix one of the genes that was abnormal and was causing this kidney disease.

So, I think because of all of the fundamental discoveries from many, many groups around the world over the past many years, we now have in hand a number of really terrific therapeutic targets to go after. So, I'm incredibly optimistic that we're going to see huge advances in kidney disease, and here at Northwestern with this Kidney Center, we really hope to be part of that, and also to help drive that and catalyze those discoveries as we go forward.

Host: Wow, really amazing, Dr. Quaggin. So, wrap it up for us. What else would you like to add, and what would you like other providers to know about the important research that you're doing on kidney disease?

Dr. Quaggin: Yeah. So most of all, I like to emphasize it's a team effort. So, it's everybody, I think, thinking about the issue of kidney disease. I would also stress to everybody, recognize that kidney disease is such a huge problem. Get your kidneys checked. It's always better to prevent kidney disease than to try to fix it. And also, I would encourage everybody to visit the web portal: www.nephroHUB.org. We plan to update that frequently, and we're really looking forward to an incredibly exciting year and decade ahead for the kidneys.

Host: Thank you so much. Thank you for all the research you're doing, and for sharing your expertise about this research that you're doing and the grant that you've gotten. Really, thank you so much. This is Better Edge: A Northwestern Medicine Podcast for Physicians. For more information on the latest advances in medicine, please visit www.NM.org. That's www.NM.org. This is Melanie Cole, thanks so much for listening.