December 16, 2001
Tulane researchers have been selected to participate in a landmark study of chronic kidney disease sponsored by the National Institutes of Health. Tulane's selection represents a triumph for the school, since many prestigious universities were turned down for the award. Seven schools were awarded grants.
"Everyone's talking about this study," said Jiang He, associate professor of epidemiology and medicine and principal investigator of Tulane's portion of the study. "It provides a very exciting opportunity to examine the natural history of renal disease and cardiovascular disease, and to figure out the risk factors for them, so we can identify effective prevention and treatment approaches."
He is also co-chair of the committee that is designing the overall study. "I am delighted that the faculty at Tulane is playing such an important leadership role," said Paul K. Whelton, senior vice president for the health sciences. "The progressive growth of competitive research at the health sciences center is not only good for our faculty, students and staff, but for our community and the state."
Tulane has a strong record in kidney research. Whelton is a pioneer in the field of kidney-disease epidemiology, which helped make the university competitive for the grant. But Tulane is a good site for the study for one less-cheerful reason as well--the New Orleans area has high rates of kidney disease and cardiovascular disease.
This will be the first large-scale comprehensive study of chronic kidney disease, and will likely affect the course of research and treatment for decades to come. Three thousand study participants with mild chronic kidney disease will be recruited nationally, about 500 of those from the New Orleans area.
Diabetes is the most common and well-known cause of kidney disease. But high blood pressure is also a common cause of kidney damage, and there are several other causes as well. The total study population will reflect the actual population of Americans with kidney disease. In the New Orleans cohort, about half the subjects will be African American.
"It's important to note that kidney disease is something that does seem to affect African Americans at higher rates," said Lee Hamm, professor and chief of nephrology, who is a co-investigator for the study and studywide chair for renal-function measures. "It's uncertain whether those higher rates among African Americans are due to genetic factors, lifestyle risk factors or a combination of both, but that's something the study should help make clear."
Participants will be studied to identify various environmental risk factors, bio-markers and genetic markers of progressive chronic renal failure and the development of cardiovascular disease among patients with minor kidney dysfunction. To that end, they will undergo extensive non-invasive tests, probably including heart imaging with Tulane's new electron beam tomography scanner. Then they will be followed for five to seven years.
Researchers hope to identify which risk factors are most closely associated with the development of more serious kidney disease, and also to learn more about the relationship between kidney disease and cardiovascular disease. "National data shows that patients with mild renal disease have much higher risk for heart attack, stroke, congestive heart failure and other cardiovascular disease," He said. "Finding out why is an important objective of this study."
New centers of renal disease and hypertension and of cardiovascular disease at the health sciences center were already in the planning stages before this grant was awarded. The establishment of the centers should help in conducting the study, and vice-versa.
Researchers will come from throughout the health sciences center and will include Whelton; Paolo Raggi, associate professor and director of preventive and non-invasive cardiology; Vecihi Batuman, professor of nephrology; Vivian Fonseca, Tullis Tulane Alumni Professor of Diabetes; and Paul Muntner, assistant professor of epidemiology. Researchers will begin recruiting patients next year.
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