Grant: Project Grant

1 in 10 Canadians has kidney disease, many of whom will progress to kidney failure, a condition that leads to impaired quality of life, higher mortality, and costs of up to $100,000/pt/year. Although kidney transplantation offers hope for such patients, donor kidneys are in short supply, with patients now waiting up to 8 years for a transplant. As such, kidneys from sicker donors are frequently used, despite the fact that they are often already scarred, a process that can reduce their lifespan. While scarred kidneys are still useable, they are best transplanted into older patients, rather than younger people who need longer lasting kidneys. Importantly, scarring affects not only donor kidneys, but also drives the progression of nearly all forms of chronic kidney disease. The only way to measure scarring currently is via looking at the kidney under a microscope. In animals, this is done by taking the kidneys out. As such, serial testing can not be performed, resulting in the needless use of many animals. In humans, scarring is assessed by biopsy, an invasive procedure that samples < 1% of one kidney and can cause bleeding. Unlike biopsy, ultrasound non-invasively images the entire kidney. Our goal is to test whether ultrasound can measure scarring in rodent and human kidneys. In rodents, we will test if through-the-skin ultrasound can track kidney scarring as it progresses (Aim 1). In human studies, we will test whether our ultrasound technique can image scarring of ex vivo donor kidneys (Aim 2). If successful, our studies could have major applications for preclinical research, by allowing easy tracking of scarring in the same animal over time. Moreover, as kidneys are removed from donors prior to transplant, our work could aid in how donor kidneys are matched to recipients, to maximize the benefit for all patients. Taken together, we expect that our results could have potentially transformative effects for the study and management of kidney scarring.