New strategy of prevention of transition from AKI to CKD

2023 Fiscal Year Final Research Report

• Project/Area Number: 21K08231
• Research Category: Grant-in-Aid for Scientific Research (C)
• Allocation Type: Multi-year Fund
• Section: 一般
• Review Section: Basic Section 53040:Nephrology-related
• Research Institution: Kochi University
• Principal Investigator: Terada Yoshio 高知大学, 教育研究部医療学系臨床医学部門, 教授 (30251531)
• Co-Investigator(Kenkyū-buntansha): 谷口 義典 高知大学, 教育研究部医療学系臨床医学部門, 講師 (70584431) ; 堀野 太郎 高知大学, 教育研究部医療学系臨床医学部門, 准教授 (90448382)
• Project Period (FY): 2021-04-01 – 2024-03-31
• Keywords: 急性腎障害 / 尿細管 / 慢性腎臓病 / 線維化 / Zeb2 / 慢性腎不全 / 透析 / PNUTS

Outline of Final Research Achievements

Currently, the number of patients undergoing dialysis therapy exceeds 340,000 nationwide, and acute kidney injury (AKI), in particular, is becoming more frequent due to the aging of patients, and it occurs in about 10% of all hospitalized patients and is chronic. It has been reported that the disease progresses to kidney disease (CKD) at a high rate and deteriorates the kidneys and life prognosis, and countermeasures are urgently needed. In this application, we will focus on fibrosis, which is one of the mechanisms involved in the transition from AKI to CKD, and will conduct a basic research on how Zeb2 and the Phosphatase-related gene (PNUTS) are involved in renal fibrosis after AKI. We will elucidate this by comprehensively using clinical methods, and examine whether Zeb2 expression can be a new biomarker for CKD transition using renal biopsy specimens from patients who have transitioned from AKI to CKD.

Free Research Field

腎臓内科

Academic Significance and Societal Importance of the Research Achievements

透析患者数は34万人を超え、その原疾患の一つである急性腎障害(AKI)の患者数と透析導入が著増している。AKIは線維化により慢性腎臓病（CKD）に移行する事が報告されており、透析患者数の減少のためには、病態の解明が急務である。本申請課題では、AKIの病態とCKDに移行するメカニズムの一つの繊維化に着目し、特にZeb2とPhosphatase関連遺伝子である(PNUTS)がAKI後の腎繊維化にどのように関与するかを基礎的・臨床的手法を総合的に駆使して解明するとともに、AKIからCKDに移行した患者の腎生検検体を用いてZeb2発現がCKD移行の新規のバイオマーカーになり得るかを検討した。