The Renal Diseases Department focuses on learning about the pathophysiology of chronic kidney diseases to inform innovative pharmacological interventions and more effective cell therapies that can reduce the incidence of these diseases and delay their onset and progression to terminal renal failure, which requires replacement therapy with dialysis and/or kidney transplantation. In particular, the unit focuses on diabetic nephropathy and non-diabetic proteinuric chronic kidney disease with a special focus on nephrotic syndromes and membranoproliferative glomerulonephritis and C3 glomerulopathies. In addition, the unit works on thrombotic microangiopathies and non-proteinuric renal diseases, particularly polycystic kidney disease. Finally, it conducts studies that investigate issues related to minimising the need for immune suppressive therapy in kidney transplantation and inducing immunologic tolerance to transplanted organs by using mesenchymal stromal cell therapy.
There are many causes of kidney disease, and the onset and evolution of a disease and the complications that may be associated with it are almost always due to the interaction between genetic and acquired factors. Discovering and understanding how these factors interact with each other in causing kidney disease is one of the overall goals of our research.
Much of this work is done in close collaboration with the Regulatory, Ethical and Legal Affairs UOC, the Rare Diseases UOC, the Department of Molecular Medicine, the Department of Bioengineering and the Azienda Socio-Sanitaria Territoriale (ASST) Papa Giovanni XXIII hospital of Bergamo. The ultimate aim is to plan the clinical research activities of the Renal Diseases UOC based on knowledge derived from basic research and the problems that emerge from routine clinical work.
Aims/Objectives
• Identify screening and intervention strategies to prevent the onset of nephropathy and other chronic complications in diabetic and/or hypertensive patients
• Formulate intervention strategies to prevent or slow the progression of chronic nephropathy and possibly achieve remission/regression of renal damage
• Design and validate innovative therapies for membranous nephropathy, idiopathic nephrotic syndromes, complement-mediated nephropathies, and adult polycystic kidney disease
• Optimise immunosuppressive therapy protocols in transplantation settings with the ultimate goal of achieving tolerance for the transplanted organ and identifying new donor selection criteria to increase the pool of available organs
METHODOLOGICAL APPROACHES
• Pilot studies in pathophysiology and clinical pharmacology conducted entirely at the centre to test new pathogenic hypotheses and new intervention modalities
• Networking and coordination of national and international multicentre trials to test the efficacy of newly identified treatments
• Measuring the performance of glomerular filtration prediction equations (eGFR) versus direct measurement of GFR
• Characterising novel imaging analysis approaches in kidney disease and responses to therapy
• Meta-analysis and development of probabilistic models to test risk factors and treatments on large samples of patients and verify their predictive value and efficacy at the individual level
• Monitoring adherence to standard operating procedures prepared by the Institute's Clinical Trials Quality Management System
