Researching the causes of hyperfiltration injury
Presented by Tarak Srivastava, MD, Division Director, Neonatology
One of the most common issues in the progression of chronic kidney disease is the occurrence of hyperfiltration injury, which can take place when a patient’s remaining functional nephrons attempt to compensate for lost ones by filtering more material. This in turn results in mechanical injury to the podocyte cells located inside the kidney’s glomerulus. Ultimately, the damage to the podocytes can lead to worsening glomerular disease and impaired kidney function.
Tarak Srivastava, MD, a nephrologist at Children’s Mercy Hospitals and Clinics in Kansas City, has a special research interest in podocyte cell biology. He is researching ways to minimize the severity of hyperfiltration injury in the glomerulus by investigating the effects of mechanical forces on the podocyte. His current findings suggest a role for prostaglandin-mediated injury to podocytes in hyperfiltration. “Our efforts in the Children’s Mercy Nephrology lab are helping physicians gain a better understanding of the events that are related to hyperfiltration injury and its role in the progression of chronic kidney disease,” says Dr. Srivastava.
Working in collaboration with other investigators from the United States and abroad who have similar research interests, Dr. Srivastava’s findings have been presented in a number of scientific forums, including the American Society of Nephrology meeting.
In addition to his work in mechanical forces on podocytes, Dr. Srivastava is also studying the role of innate immunity in podocytes to better understand the mechanisms underlying development of the nephrotic syndrome. Dr. Srivastava is an active participant in the FSGS clinical trial (FONT II), which is investigating therapies for treatment-resistant patients. Children’s Mercy is also a participating member of the Midwest Pediatric Nephrology Consortium, which provides Dr. Srivastava an opportunity to collaborate with other pediatric nephrologists around the country in order to gain a better understanding of the immune system and other factors that may contribute to the development of minimal-change disease, the most common form of nephrotic syndrome in children.
Dr. Srivastava believes that his role as both clinician and scientist gives him a unique perspective. “It’s exciting to identify clinical problems on the hospital ward or in the clinic, and then move to the lab to attempt to better understand the pathophysiology and potential treatment of the disorder,” he says. No doubt his patients and others are likely to benefit from this practice.