Chronic kidney disease is a rapidly growing problem in the US. The National Institute of Diabetes and Digestive and Kidney Diseases reports that by 2010, the number of people with kidney failure will approach 700,000, while the annual cost of treating kidney failure has already topped $20 billion. Advanced chronic kidney disease results in a severe condition called kidney failure. Once kidney failure has set in, a patient must either start kidney dialysis or seek a kidney transplant. With the rise in chronic kidney disease, research on improving kidney transplantation has become a pressing issue.
Bertram Kasiske, MD, is a specialist in nephrology at Hennepin County Medical Center. He has been conducting clinical research on the various forms of kidney disease for 26 years. Currently, the main focus of his work is kidney transplantation and transplantation outcomes. He collaborates on many of his research projects with Dr. Ajay Israni, another MMRF researcher who is studying kidney transplants.
Dr. Kasiske’s work explores why kidney transplants fail and why complications arise in transplant recipients. Currently, kidney transplant candidates who are at high risk for major, adverse cardiac events undergo non-invasive stress testing and/or coronary angiography. Candidates with significant coronary disease then undergo preemptive angioplasty or coronary artery bypass to prevent these problems from emerging post-transplant. However, recent findings suggest that this strategy may be ineffective and may only add to the heavy health and financial toll kidney transplant patients pay.
One of Dr. Kasiske’s studies is called the Coronary Screening for Kidney Transplantation Study (COST), funded by the National Institutes of Health (NIH). It is exploring whether the benefits of screening tests outweigh the associated costs and risks to kidney transplant patients. If this study shows that screening asymptomatic kidney transplant candidates with stress tests and coronary angiographies does not improve outcomes, it could substantially reduce the financial and health impact on kidney transplant candidates.
Dr. Kasiske is conducting several studies sponsored by the NIH. In one study, he is following the long-term outcomes for kidney donors to see if any complications arise later in their lives. He plans to continue this research as long as funding is available from the NIH or for as long as the participants live.
Dr. Kasiske believes that the advances that have been made in treating kidney disease are truly remarkable. Only fifty years ago we were not able to do any kidney transplants and today, because of improvements in technology and medical knowledge, we can do very complicated procedures and transplants that save people’s lives.