Every day, you depend on your kidneys to filter your blood and keep it healthy. But if your kidneys fail - perhaps due to injury or a chronic condition like diabetes - you could need artificial dialysis or a transplant to stay alive.
Dr Tara McMorrow, a UCD Conway Institute Investigator, Lecturer in Pharmacology in the UCD School of Biomolecular and Biomedical Science and a group leader of the Renal Disease Research Group, is working on several angles to help. She wants to better understand what happens to cells as kidneys get damaged and fail, and to work out how to spot the warning signs of kidney problems earlier so doctors can intervene before it's too late for the failing organ.
It's an important area for Ireland: reports suggest that one in 9 people here have some form of kidney damage, according to Dr McMorrow. "The majority of these people will not know they have any kind of kidney damage until they require dialysis, which can mean being hooked up to a machine for hours two or three times each week," she says.
So what happens in the kidney to cause it to fail so catastrophically? One aspect seems to involve a change in epithelial cells that line the tubules in the kidneys. They switch to a more wound-healing type of cell, and this causes scarring to build up.
"Just like if you cut yourself, the scar that forms would be called the fibrosis, and this is what happens to the kidney," explains Dr McMorrow. "And it strangles the kidney so it can't function."
Her research looks at various cellular processes that are implicated in this scarring, which may still be an issue even after transplant: anti-rejection drugs may also encourage scarring and the 'new' kidney becomes damaged over time.
"At the moment we have nothing to block that damage," explains Dr McMorrow. "And it's too late by the time we can detect it in a patient. But if we could detect it at an earlier point then the person could be helped to maintain kidney function for a lot longer."
That's why the group at UCD is working closely with clinicians at Beaumont and St Vincent's University Hospitals to look for useful 'biomarkers' of damage that could give clinicians an early warning sign that something is going awry in the kidneys.
"If you can maintain the function even at approximately 30 per cent you can maintain renal function for several more years, so it delays the need for dialysis and transplant," says Dr McMorrow.
They are also involved in a European project called SYSKID, which is studying kidney disease as a complication of diabetes. The idea is to find markers of damage that show up in easily obtained patient samples, such as urine.
"We are analysing potential early biomarkers and genes we have identified in our screens that could possibly be used as early signals of kidney damage," explains Dr McMorrow. "And this project is looking to screen significant numbers of patients with diabetes throughout Europe to identify them."
The Renal Disease Research Group is currently funded by EU 6th and 7th Framework programmes, MRCG-HRB joint funded programme, CEFIC-LRI programme and the American Cystinosis Foundation.
Dr Tara McMorrow was interviewed by freelance journalist Dr Claire O'Connell
