Patients with end stage renal disease (ESRD) face an increased risk of death due in part to cardiovascular problems caused by chronic inflammation. Efforts to reduce this inflammation have tended to target dialysis-related procedures and the accumulation of toxic waste products. These efforts have been largely unsuccessful, and researchers, such as Keiichi Sumida, MD, MPH, PhD, associate professor in the Division of Nephrology in the College of Medicine at UTHSC, are beginning to look at other possible causes.
Dr. Sumida has received a $2.9 million grant to pursue his study of microbial populations circulating in the blood of patients with kidney failure. The award from the National Institute of Diabetes and Digestive and Kidney Diseases, a division of the National Institutes of Health, will support his project, titled “Circulating microbiome and premature mortality in hemodialysis patients.” The project focuses on whether microorganisms exist in the blood of ESRD patients, where they come from, and what roles they play in the disease.
Dr. Sumida first became interested in the relation of the microbiome to chronic kidney disease about five years ago. “I have been particularly interested in the potentially underrecognized roles of the gut, specifically the multi-directional, pathophysiological interactions between the gut, kidney, and heart (also known as the gut-kidney-heart axis),” said Dr. Sumida. “When I started looking into the microbiome’s role in the gut-kidney-heart axis in ESRD patients, the available data were primarily based on the microbiomes obtained from other body sites than the blood (e.g., gut, oral cavity, and skin). Although there is no doubt the microbiome plays an important role in each body site, I thought it possible that the circulating microbiome could exert its biological effects as a ‘downstream site’ of action in the entire body, reflecting the alterations of highly complex microbial communities in different body sites.”
Dr. Sumida’s findings could pave the way for future development of new diagnostic and prognostic biomarkers, and lead to target-driven therapies and treatment. “I hope that our study will uncover novel mechanisms underlying the gut-kidney-heart axis and ultimately help improve outcomes of patients with ESRD.”