I’m often asked “What do you do?” In order to avoid those glazed over looks, and in honor of World Kidney Day, I present to you Dr John’s five minute intro to his study of Acute Kidney Injury (AKI).
What is Acute Kidney Injury and why does it matter?
AKI is the very rapid loss of kidney function. As the kidney is a big filter designed to clean your blood this means you won’t be able to get rid of the nasties and that ain’t good news (see this previous post for some of the other great things kidneys do).
AKI is not about getting punched in the kidneys. Lots of things can cause the kidney to fail. If the blood ceases to run to the kidneys for a short time (e.g. during a heart attack) then no oxygen gets delivered to them. All cells need oxygen, so lack of it means curtains for some cells. Other causes are when parts of the kidney get poisoned. Given that the kidney concentrates the nasties in the blood, it is the first place to get hit by poisons.
About one third of people entering the intensive care have or get AKI. That’s heaps annually (heaps is a technical term used by scientist to mean “more than we can get funding to count”). If you have AKI you are more likely to die, need dialysis, get Chronic Kidney Disease and you will spend more time in hospital. So, it’s kinda important (bean counters – note: it costs billions annually). These things are all summarised in my latest minfographic below.
What do I study?
Most of my work is about how to figure out people have AKI. The problem is that for the last 70 years or so AKI has been able to be detected only a day or three after it has occurred! This is too late to do much about it (dialysis only supports the kidney, not cures). Think about this analogy (remember the kidney is a big filter): Imagine you a running water in the sink. It goes down the plughole OK. You are defrosting some meat (the old fashioned way), so you wander away and leave the water running. Unknown to you, there is some hair stuck down the drain (yuk), which gets shifted around a bit until it largely blocks the drain. The inevitable happens and the drain and then sink fill up and, of course, overflow. What my colleagues and I do is to look at the other end of the drain for any tell-tale signs that there is something amiss (yep, we look in the urine. I guess that makes us pee scientists). That something amiss is a very small molecule which only the clever scientists in the labs can extract from the urine and quantify. For the past decade or so there have been many such small molecules discovered (new techniques and technology have helped) which are potential early indicators of AKI. We call these “biomarkers.” My job is to analyze the numbers the lab people give me. I try and see if and when particular biomarkers are in greater concentrations in the urine and try and match this to the clinical outcomes of patients. The hope is that we will learn enough about these biomarkers to know when and how to use them in clinical practice. If we can detect AKI when it first occurs, then we should be able to develop new treatments and finally be able to do something about the death rates and other poor outcomes.