Grant: Operating Grant

Heart failure (HF) is a major contributor to poor quality of life, a leading cause of hospitalization and of premature death. Kidney disease is major and independent risk factors for the development of heart failure, such that individuals with chronic kidney disease (CKD) are at especially high risk of developing HF. Such patients are not only likely to have coronary artery disease and high blood pressure but are also likely to have damage to the heart muscle itself, an entity referred to as cardiomyopathy. Studies from our group and others have shown that in the setting of kidney injury both the kidney and heart lose their small blood vessels (microvasculature). As a consequence, blood supply is reduced and the tissues become starved of oxygen and other nutrients. This leads to impaired function in both the heart and kidney. Recent studies by our group have shown that the microvascular loss can be prevented by the administration of cells from the bone marrow. This treatment also substantially improved both heart and kidney function also. The present proposal seeks to perform further studies to ascertain the mechanisms underlying the observed benefit and to provide further information regarding the feasibility of using this approach in humans with CKD and HF.