Chronic Diseases

Key Researcher

picture of MMRF researcher Dr. Allan CollinsAllan Collins, MD, FACP, received his Medical Degree from Wayne State University. He has over thirty years of experience in nephrology and End Stage Renal Development (ESRD) treatment. His clinical experience and research have focused on acute and chronic care of ESRD patients and prospective and retrospective clinical studies on dialysis techniques and associated outcomes. He has also done extensive work with high-efficiency dialysis and therapy prescription and the technical elements of dialysis.


Chronic diseases are the leading cause of death in the United States. They result in long-term and permanent disability for millions of Americans, with serious quality-of-life consequences for them and their families, and with enormous economic consequences for individuals, health plans, and the country.

A division of the Hennepin Healthcare Research Institute (HHRI), the Chronic Disease Research Group (CDRG), investigates public health issues related to chronic illness and its treatment. CDRG seeks to improve public health and to influence health policy, healthcare providers, and health plans by helping industry planners better understand and respond to patient needs.

CDRG was founded in 1995 as Nephrology Analytical Services. Under the leadership of HHRI investigator Allan Collins the research agenda has expanded beyond kidney disease to include other chronic conditions. Clinical specialists in cardiovascular disease, chronic kidney disease, dementia, diabetes, ESRD, geriatrics, nephrology, and pharmacy work with epidemiologists and biostatisticians to analyze disease conditions and evaluate the effects of treatment on morbidity, survival, quality of life, and healthcare costs.

Suggested Links*

American Association of Kidney Patients

American Diabetes Association

*HHRI is not responsible for the content on external websites. The appearance of these links on the HHRI website does not constitute an endorsement by HHRI.


 

Key Researcher

picture of MMRF researcher Dr. Bert KasiskeBertram Kasiske, MD, FACP, is the Director of Nephrology at Hennepin County Medical Center and a Professor of Medicine at the University of Minnesota. He serves as Project Director for the Scientific Registry of Transplant Recipients (SRTR), a national database of transplant statistics to evaluate the scientific and clinical status of solid organ transplantation, including kidney, heart, liver, lung, intestine, and pancreas, funded by the Health Resources and Services Administration (HRSA). He also serves as the US Principal Investigator for the Study of Heart and Renal Protection (SHARP), a multicenter trial of cholesterol lowering treatments in patients with chronic kidney disease and a Co- Investigator for the Study of Long-Term Kidney Deterioration of Kidney Allograft Function, a study of long term outcomes after kidney transplantation sponsored by the National Institutes of Health (NIH).


 

Chronic kidney disease is a rapidly growing problem in the US.  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 is a specialist in nephrology at Hennepin County Medical Center (HCMC). He has been conducting clinical research on the various forms of kidney disease for over 25 years. Currently, the main focus of his work is kidney transplantation and outcomes.

Dr. Kasiske’s work explores why kidney transplants fail and complications in recipients. Currently, 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 patients pay.

Dr. Kasiske believes that the advances that have been made in treating kidney disease are truly remarkable. Only fifty years ago it was not possible to do any kidney transplants and today, because of improvements in technology and medical knowledge, very complicated procedures and transplants can be done to save people’s lives.

Suggested Links*

American Journal of Kidney Disease

National Institute of Diabetes and Digestive and Kidney Diseases

National Kidney Foundation

*HHRI is not responsible for the content on external websites. The appearance of these links on the HHRI website does not constitute an endorsement by HHRI.


 

Key Researcher

picture of MMRF researcher Dr. Ajay IsraniAjay Israni, MD, MS, HHRI Interim President, completed his Medical Degree from New York University. He is board certified in Internal Medicine and Nephrology and is a transplant nephrologist at Hennepin County Medical Center. He serves as Deputy Director for the Scientific Registry of Transplant Recipients (SRTR), a national database of transplant statistics to evaluate the scientific and clinical status of solid organ transplantation, including kidney, heart, liver, lung, intestine, and pancreas, funded by the Health Resources and Services Administration (HRSA), and Project Director for the Genomics of Transplantation, a multicenter, international study sponsored by the National Institutes of Health (NIH) to investigate the impact of recipient and living donor genotypes on renal allograft outcomes.

Within 11 years, half of all kidney transplants received from deceased donors will fail in the recipient’s body. Patients whose transplant fails often will not receive a replacement kidney in time to save their lives. Kidney transplant failure is a growing problem in the US. In 2009, there were over 17,000 kidney transplants in the US – a figure that will likely grow as Americans suffer from more chronic diseases.

Dr. Israni was exposed to the consequences of kidney transplant failure while caring for kidney recipients as a transplant nephrologist. He became interested in how genetic variability affected the long-term outcomes for the kidney recipients he treated.

When the human genome was mapped, researchers discovered that 90 percent of human genetic variability is due to single nucleotide changes in the DNA molecule (nucleotides are the parts of the DNA molecule that look like steps in a ladder).

By understanding the effects genetic variations have on long-term kidney function, Dr. Israni hopes his work will provide critical information that could help increase the viable life-span of transplanted kidneys in recipients’ bodies. A deeper understanding of the genetic interactions at play in kidney transplants will allow doctors to clinically screen patients before a transplant. Once the genetic variants associated with poor long-term kidney transplant success have been identified, scientists will be able to develop new and specific strategies to target those patients who are at a higher risk of long-term kidney transplant failure.

To carry out his research, Dr. Israni is collecting samples from recipients and donors to sequence their genomes to see which gene variations lead to a higher rate of transplant failure. His approach is multi-disciplinary, looking at both the genetics and the way the drugs are metabolized by recipients. Genetic samples come from several sites around the US and Canada.

Dr. Israni’s work shows how understanding the human genome will allow doctors to consider the unique genetic make-up of each individual and prescribe treatment regimens specifically tailored to that individual’s needs.