Critical Care Nephrology
Dr. Patrick Murray has a clinical research focus in Critical Care Nephrology. He studies approaches to prevent, treat, and provide renal replacement therapy for acute renal failure. He studies the renal and systemic effects of vasoactive drugs such as fenoldopam and vasopressin in critically ill subjects (in collaboration with investigators from the Critical Care sections of the Departments of Anesthesia and Medicine). He studies methods to improve hemodynamic stability, anticoagulation, and outcome in patients requiring renal replacement therapy. He is also conducting a randomized trial of vitamin D therapy in hypocalcemic ICU patients.

Chronic Kidney Disease

Dr. Patrick Murray conducts clinical trials of anemia therapy using erythropoeitin for patients with chronic kidney disease, in collaboration with Dr. Bharathi Reddy and Dr. Pradeep Kadambi.

Dr. Orly Kohn is the site principal investigator for the NIH-funded Family Investigation of Nephropathy and Diabetes (FIND) study. Diabetic nephropathy develops in less than half of all diabetic patients. It has long been noted that diabetic nephropathy occurs in familial clusters and disproportionately affects certain minority populations. The FIND study is a multicenter consortium established by the NIH to identify the genes that modify susceptibility to diabetic nephropathy. Minority diabetic nephropathy patients with diabetic siblings are recruited for linkage analysis. Participants provide medical history, blood and urine samples. Diabetic siblings with or without nephropathy are eligible for the family study. FIND is establishing a repository of genetic and biologic samples and a database which will allow identification of genes critical to the development of nephropathy and ultimately therapeutic strategies to prevent this complication.

End-Stage Kidney Disease

Renal Bone Disease. The Nephrology faculty is participating in trials of new therapies to treat bone disease in patients on long-term dialysis. These include a calcimimetic agent, in collaboration with the Section of Endocrinology, Diabetes and Metabolism, as well as studies of the use of two vitamin D analogues, carried out by Dr. Nicole Stankus. This study will look at both efficacy in treatment of hyperparathyroidism, as well as impact on survival.

Improvement of Dialysis Methods. Adequate delivery of hemodialysis treatments requires dependable and infection-free access to the circulation, and prevention of clotting of the dialysis circuit. Recent protocols conducted in our dialysis units have studied methods to prevent thrombosis and infection of the dialysis access or circuit. Dr. Mary Hammes has conducted a study to determine if intranasal antibiotic ointment prevents catheter-related bacteremia in hemodialysis patients. She has also shown the efficacy of a new thrombolytic agent to open clotted dialysis catheters. Dr. Nicole Stankus is conducting studies of a new agent that may help to prevent growth of scar tissue and clotting in dialysis grafts. This research may prolong the useful life of the access, which is critical to delivery of adequate dialysis. Drs. Reddy, Hammes and Murray completed a trial demonstrating the efficacy and safety of a novel anticoagulant (argatroban) for use during hemodialysis.

Transplantation

Drs. Michelle Josephson and Pradeep Kadambi study ways to prevent medical complications of kidney transplantation and improve the outcome of the transplant recipient. These approaches include participation in the NIH sponsored multi-center trial of solid organ transplantation in HIV+ patients, evaluating the efficacy of erythropoetin therapy in kidney transplant recipients, doing pioneering work on the potential role of leflunomide in treating and controlling infection with the polyoma virus BK.

As The University of Chicago is one of the few centers in the country with expertise in multi-organ transplantation, they are investigating outcomes of these highly complex transplants. They are also studying the impact of recurrent and de novo glomerular diseases on the outcomes of transplanted kidneys and participating in studies aimed to identify safe and effective immunosuppression regimens. These regimens include steroid and calcineurin inhibitor reduction, avoidance and/or elimination protocols as well as study of leflunomide’s potential to prevent chronic rejection. They are collaborating with the kidney stone group to set up a multi-center study that investigates the controversial area of whether kidney stone formers can safely donate kidneys.

Kidney Stones

Dr. Fredric Coe directs the renowned Kidney Stone Clinic and in collaboration with Dr. Elaine Worcester conducts studies on the causes of kidney stones and prevention of recurrence.

Glomerulonephritis

Dr. Richard Quigg conducts clinical studies of novel therapies of immune glomerular diseases including membranous nephropathy and lupus glomerulonephritis. In addition, Dr. Quigg is studying the expression of genes that are relevant to disease in patients with various glomerular diseases, including lupus nephritis, membranous nephropathy and diabetic nephropathy. These studies are being carried out in the University of Chicago Functional Genomics Facility which Dr. Quigg directs, as well in collaborative studies with Gene Logic, a biotechnology company based in Maryland.