Research Suggests Protein Deficiency May Be Responsible For Chronic Kidney Disease

Millions of us in the United States and an estimated 200 million people around the world struggle with chronic kidney disease (CKD). It’s a condition that emerges incrementally over a number of years. Anyone can develop chronic kidney disease, and it’s a growing concern in the United States. New research, however, points to a circulating protein that may be responsible for the decline in kidney function.

Our kidneys filter the wastes and extra water from our blood. When chronic kidney disease emerges, the kidneys cannot filter the blood properly. Chronic kidney disease cannot be “cured,” but if it is detected in its early stages, it can often be adequately managed with the proper medications. If kidney disease is not properly treated, a complete kidney failure is eventually inevitable.

A team of researchers at the Tufts Medical Center studied the link between levels of a protein called soluble klotho and kidney function. The research was published in the Journal of the American Society of Nephrology. Researchers state that “CKD appears to be a condition of soluble klotho deficiency.” Decreased blood levels of the protein were linked with a higher likelihood of declining kidney function in a group elderly, well-functioning adults.

HOW WAS THE RESEARCH CONDUCTED?

Researchers assayed serum soluble klotho in 2,496 participants in the National Institutes of Health’s ongoing “Health, Aging, and Body Composition” study, evaluating the link between soluble klotho and the emergence of chronic kidney disease over a ten-year follow-up period. The average age of the participants was 75. Just over half – 52 percent – of the participants were women.

Lead researcher Dr. David Drew said, “We found a strong association between low soluble klotho and decline in kidney function, independent of many known risk factors for kidney function decline. This suggests that klotho could play a role in the development of chronic kidney disease, although additional research will need to confirm this. This also raises the possibility that klotho could be an important therapeutic target for future clinical trials.”

Specifically, for each two-fold higher level of soluble klotho, the scientists found a 20 percent lower risk of kidney function decline throughout the follow-up period. The researchers’ results did not change after adjustment for key variables including demographics, comorbidities, and a number of kidney disease risk factors. Higher levels of soluble klotho are associated independently with a reduced risk of declining kidney function.

HAS PREVIOUS RESEARCH LINKED PROTEIN LEVELS TO KIDNEY DISEASE?

The study of soluble klotho levels follows a 2015 study of another protein, TMIGD1, and its impact on kidney function. When researchers at Boston University reduced the TMIGD1 protein in kidney epithelial cells, the cells became more prone to injury. When they increased the levels of TMIGD1, the increase seemed to protect the cells from being injured. Researchers thus determined that increasing the level of the TMIGD1 protein reduces kidney epithelial cell death, thus possibly helping patients to avoid chronic kidney disease and declining kidney function.

Here in the United States, approximately 20 million of us suffer from chronic kidney disease, which, according to the Wall Street Journal, currently costs Medicare more than $41 billion every year. Many people don’t even know that they have chronic kidney disease until their kidney problems become severe. It’s imperative for chronic kidney disease sufferers to be swiftly and accurately diagnosed and to receive the appropriate medical treatment. With an early and accurate diagnosis, the progress from early-stage chronic kidney disease to complete renal failure can be slowed and in some cases halted altogether.

If a urine test finds blood and protein in a patient’s urine, it probably means chronic kidney disease, and the patient should be retested. If the same levels of blood and protein are found in a second test, the patient should be sent to a nephrologist – a kidney specialist. If a blood test finds a reduced protein level in a patient’s blood, the kidneys may not be adequately filtering the blood. A number of tests are available for identifying kidney disease, including:

  • tests for blood (hematuria) and protein (proteinuria) in the urine
  • blood tests for decreased protein, increased creatinine, and abnormal blood urea nitrogen
  • blood pressure measurements
  • glomerular filtration rate tests
  • MRIs, CT scans, and kidney biopsies

HOW IS MEDICAL MALPRACTICE DEFINED?

However, if a patient’s test results are misread or go unrecognized because a doctor has been inadequately trained – or for any other reason – that constitutes medical malpractice. In such circumstances specialists may not be consulted, treatment may not be ordered, and a patient’s health can rapidly decline. Medical malpractice is the violation of the “reasonable standard of care” provided by most doctors, but it’s often difficult for the average person to know if he or she is a victim of medical malpractice. A CKD patient may need to speak with an experienced medical malpractice attorney to determine if medical malpractice has occurred.

Every malpractice case is different, and any allegation of medical malpractice must be thoroughly considered from both the legal and medical angles. Providing a reasonable standard of care does not obligate doctors to order every possible test. Instead, physicians are expected to offer competent, professional care comparable to what other doctors would offer in similar situations:

  • Doctors should order the tests that are “reasonable” and standard.
  • Doctors should study the results of those tests in a timely manner.
  • In difficult cases, a doctor should consult a specialist.
  • If a chronic kidney disease is identified, the patient should be sent to a nephrologist.

If a doctor does not provide a reasonable standard of care, he or she may be considered negligent. If that negligence causes injury or harm to a patient, that patient is entitled to financial reimbursement and may file a medical malpractice claim. Medical malpractice victims can be compensated for lost income and earning capacity, for the cost of additional medical treatment, related expenses, and sometimes for pain and suffering as well.

Malpractice itself cannot cause kidney disease, but the failure of a patient to have an accurate early diagnosis and appropriate continuing treatment can lead directly to acute renal failure. Anyone who believes that medical malpractice has exacerbated his or her kidney disease – and anyone whose health has deteriorated after kidney treatment that should have improved it – should consult an experienced medical malpractice attorney regarding his or her rights and the possibility of legal action.

By: Jed Kurzban

Medical malpractice attorney Jed Kurzban graduated from the University of Alabama in 1992 and earned his Juris Doctor from the University of Miami School of Law in 1995. He is a member of the Dade County Bar Association, the Florida Bar Association, the American Association for Justice, the Academy of Florida Trial Lawyers, and the American Bar Association. Mr. Kurzban is happily married and the father of two.