Under the direction of Christopher S. Wilcox, MD, PhD, the Division of Nephrology and Hypertension have a number of research programs that are closely interrelated and collaborative:
- Microvascular disease in patients with hypertension, kidney and vascular disease or HIV. Dr. Wilcox directs this program with Dr. Wang. Gluteal skin biopsies are obtained from patients and controls under local anesthesia. They are studied in the laboratory for function (endothelial function and contractile responses), mediator release (nitric oxide, reactive oxygen species), calcium signaling and gene and micro RNA expression. The goal is to understand the mechanisms of microvascular dysfunction in human disease.
- The current focus of the laboratory is on non-invasive methods to assess microvascular disease. The laboratory uses Laser Doppler flowmetry to measure skin blood flow in response to local heating or to iontophorese acetylcholine, both of which assess endothelial function. Large vessel function is assessed from pulse wave velocity and ancle brachial pressure index. Peripheral capillary rarefaction is assessed by nail fold capilloscopy and cardiac output by impedance cardiography. There is a quantitative ergometric stationary bicycle and metabolic cart to study exercise physiology and ambulatory monitors to track BP, pulse wave velocity and cardiac output. Novel methods of intradermal drug delivery by an implanted permeable porous catheters are being developed to test the effects of drugs on the peripheral circulation in human subjects.
- Diuretic drug development studies: Dr. Wilcox is leading a project supported by an NIH grant to investigate a new extended release formulation of a diuretic. Phase 1 studies have been completed successfully and phase 3 studies in patients with CHF or CKD are underway.
- Drug development studies in nephrotic syndrome: Drs. Wilcox and Shen are initiating a clinical trial of a novel strategy to treat patients with nephrotic syndrome.
- Human Cardiovascular Function Laboratory: Drs. Wilcox and Wang are establishing the new, fully equipped human physiology lab to study renal and circulatory function in humans with hypertension or CKD.
- Hypertension trials: Dr. Lipkowitz is studying the role of novel genes in kidney and hypertensive diseases.
- Multicenter studies of treatment for hypertension or kidney disease. Dr. Papademetriou directs this program at the Washington VAMC. He participates in many multi-center clinical outcome trials.
- Biomarker for acute kidney injury: Dr. Palant and colleagues at the Washington VAMC have a collaborative trial with the NIH intramural program to test micro-RNAs as early biomarkers for AKI.