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News and Features Researching hyperfiltration injury by examining the impact of mechanical forces

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Innovative research provides further insight about hyperfiltration injury to the prodocyte in children

As a clinician and scientist, Tarak Srivastava, MD, a nephrologist at Children’s Mercy Kansas City, brings a unique perspective to his search for the cause of hyperfiltration injury. Dr. Srivastava draws on his experiences with patients in clinical settings as he conducts laboratory research into podocyte cell biology and the effects mechanical forces have on podocytes.

Tarak Srivastava, M

"We’re trying to find out at what point the process of adaptation eventually become injurious and damaging to the kidney," said Dr. Srivastava. 

Shedding Light through Laboratory Research

Early findings suggest that prostaglandin E2 may play a role in podocyte cell injury by interfering with EP2 and EP4 receptors.

"We’re already looking at a couple of chemicals that we may use to block or augment these pathways, depending on the role of the pathway in podocyte injury," Dr. Srivastava added. "Once we know how to tackle these changes, we will be able to develop drugs to address disease progression in kidney conditions associated with hyperfiltration mediated injury."

Collaborating to Better Understand Idiopathic Nephrotic Syndrome

"Life with your own kidneys is markedly superior to a transplant or dialysis," said Dr. Srivastava. "Even though those therapies play important roles, there are certainly risks that patients encounter because of them. So, if we could add 10 to 15 years to a patient’s life without the need for renal replacement therapy, that would be a big achievement."

Children’s Mercy is one of the few centers around the world investigating the mechanical forces that can affect podocyte cells.

Research Studies Related to Idiopathic Nephrotic Syndrome

In addition to his work on hyperfiltration injury, Dr. Srivastava is studying the role of innate immunity in podocytes to better understand the mechanisms behind 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 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.

Through all of his work, Dr. Srivastava believes his dual role as both a clinician and scientist is an asset.

"I enjoy doing both," Dr. Srivastava said. "Luckily, I’m part of a team that has mutual respect for each other, and that works really well together as we attempt to better understand the podocyte, and its role in the pathophysiology and potential treatment of hyperfiltration injury and disorders such as nephrotic syndrome."

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