Cincinnati Children’s Division of Nephrology has been named an NIH Center of Excellence in pediatric nephrology. The honor went to only three pediatric nephrology centers nationwide.

The award brings the Division $4 million over five years. Collaboration among disciplines is a major requirement of the award, as is serving as a resource to individuals around the world who are conducting research into pediatric kidney disease.

“Our goal as a Center of Excellence is to tackle some of the most vexing and difficult problems afflicting children with kidney disease worldwide,” says principal investigator and Division Director Prasad Devarajan, MD.

Three focus areas

The division has already developed research and clinical prowess in three major areas of kidney disease: acute kidney injury, nephrotic syndrome and lupus nephritis.

“All three are areas of clinical and research strength that we have collaboratively built over the last 10 years,” Devarajan says. He credits the strength to close teamwork with a variety of divisions throughout the medical center. For clinical research endeavors, the division works closely with Critical Care, the Heart Institute, the Cancer and Blood Diseases Institute, and Rheumatology.  Extensive basic science collaborations exist with Developmental Biology, Bioinformatics, Epidemiology and Environmental Health.

As one of the nation’s leading centers for pediatric kidney disease, consistently rated among the top three by US News and World Report, Cincinnati Children’s has more experience than most in caring for children whose kidneys are compromised by illnesses or by the therapies used to treat them.

Furthering work with biomarkers

Devarajan and his team developed a breakthrough biomarker test that identifies kidney problems early, before serious damage occurs. They will use the Center of Excellence funding to advance this work, hoping to use biomarkers in a more predictive way.

“We are exploring biomarkers that might allow doctors to predict which children are more vulnerable to kidney involvement as a result of their disease or treatment,” he says.

He points to research geared toward patients with lupus nephritis as an example.

“We are looking for novel, non-invasive biomarkers to indicate when a patient with lupus is progressing to kidney disease. We have patented biomarkers now to indicate who is going to have a flare of lupus nephritis about one month before it occurs. What are these markers telling us in terms of response to therapy? Who is going to get worse soon? Who is going to hang on? Once we know, we can better treat them,” he says.

Core laboratories will be a global resource

The award also will fund staff in Cincinnati Children’s core laboratories in Genomics, Proteomics, and Biomarkers who will be dedicated to working on kidney disease. They will help scientists develop new biomarkers and build basic science models; their findings will serve as a resource to doctors and researchers worldwide.

Devarajan’s goal is to use the Center of Excellence award to help change the course of a childhood killer.

“People used to think that children died with acute kidney injury, but we now know beyond the shadow of a doubt that children die of acute kidney injury,” he says. “It is a complication of the therapies we give our patients, and of advanced disease in other organ systems. It has generated an epidemic all over the world, and we need to put an end to it.”