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Dr. Lakshman Gunaratnam - Protecting patients who experience kidney failure

Dr. Lakshman Gunaratnam is on a mission to improve the outcomes of acute kidney injury and acute kidney failure — conditions that affect approximately five to 10 per cent of hospitalized patients around the world.

In a recent study Dr. Gunaratnam, assistant professor in the Departments of Medicine and Microbiology and Immunology, and his team set out to determine if the protein kidney injury molecule-1 (KIM-1) plays a role in acute kidney injury, which is the sudden onset of kidney failure.

In order to do this, they subjected knockout mouse models to a type of acute kidney injury known as ischemia-reperfusion injury, which is the most common cause of kidney failure in humans. The animal models that did not have the KIM-1 gene not only experienced worse injury and kidney dysfunction, but also failed to completely recover by the end of the experiment.

Dr. Gunaratnam explained this shows that the KIM-1 gene has an important role in kidney injury and/or repair.

“We did not study the specific role or exact contribution, but we know for sure that this protein is important,” he said. “It may suggest that in the future we can target treatment for acute kidney injury by looking at drugs or chemicals that affect KIM-1 function in the hopes of improving outcomes after acute kidney injury.”

Before he and his team venture into developing treatments for patients, however, they need to understand the detailed mechanism of how KIM-1 protects against acute kidney injury.

“We need to be cautious, because other work has shown that in certain circumstances KIM-1 can be harmful to patients as well,” he said.

There are a number of reasons Dr. Gunaratnam is interested in this research. He wants to help improve the outcomes of patients that experience acute kidney injury or acute kidney failure, as they have an increased chance of developing permanent kidney damage and could potentially end up on dialysis, or worse, die.

Understanding ischemia reperfusion injury in the animal models could also help tackle the same problem in patients receiving kidney transplantation.