Timothy W. Meyer, MD
Professor of Medicine
Chief, Division of Nephrology
Progression of Renal Disease
A number of factors contribute to progressive nephron loss once the kidney is damaged by disease. These factors include increases in glomerular capillary pressure and glomerular volume, alterations in glomerular epithelial cell structure, and tubular atrophy. Current research efforts are directed toward discovering the mechanisms responsible for these changes, and testing new drug therapies designed to retard the progression of experimental renal disease. Animal studies involve measurement of renal function, administration of experimental drugs, and evaluation of glomerular structure by morphometry. Clinical studies involve follow-up measurements of kidney function and structure in patients with chronic renal insufficiency.
The nature of the toxic chemicals that build up in patients without kidneys is surprisingly little understood. Without better knowledge of these chemicals, it is hard to improve renal replacement therapy. Current research efforts are directed toward identifying protein-bound small molecules which accumulate in uremia. The clearance of these molecules during dialysis, CVVH, and CVVHDF is then modeled and measured. Clinical studies involve testing the ability of different renal replacement prescriptions to improve clearances of the molecules of interest.
- Oberbauer R, Schreiner GF, Biber J, Murer H, Meyer TW. In Vivo suppression of the renal Na+/Pi cotransporter by antisense oligonucleotides. Proc Natl Acad Sci USA 93:4903-4906, 1996.
- Pagtalunan ME, Miller PL, Jumping-Eagle S, Nelson RG, Myers BD, Rennke HG, Coplon NS, Sun L, Meyer TW. Podocyte loss and progressive glomerular injury in Type II diabetes. J Clin Invest 99:342-348, 1997.
- Pagtalunan ME, Olson JL, Tilney NL, Meyer TW. Late consequences of acute ischemic injury to a solitary kidney. J Am Soc Nephrol 10:366-373, 1999.
- Javaid, B., Olson, J.L., Meyer, T.W. Glomerular injury and tubular loss in adriamycin nephrosis. J. Am Soc. Nephrol., 12:1391-400, 2001
- Meyer TW, Leeper EC, Bartlett DW, Depner TA, Lit YZ, Roberston CR, Hostetter TH. Increasing Dialysate Flow and Dialyzer Mass Transfer Area Coefficient To Increase the Clearance of Protein-bound Solutes. J. Am Soc Nephrol, in press