KTX360° study
In the next IMMEDIATE insight, Olena Potapenko and Johannes B. Holle from Charité dive deeper into the KTX360° study. The KTX360° study is a multi-centre study conducted from 2018-2021 that followed patients after kidney transplantation. It is a part of work package 2 focused on unravelling shared and non-shared inflammation signatures in the transition from health to disease in the domains of metabolic, cardiovascular, kidney and brain functions.
Chronic kidney disease and the need for transplantation
Chronic kidney disease is a highly affected life disorder and often leads to other health problems as it progresses. Healthy kidneys naturally filter out the solutes accumulating in the blood. With a reduction in kidney function, harmful substances called uremic toxins build up in the blood. At some point, the patient needs to get dialysis to remove these toxins. Despite the huge progress in this treatment procedure, patients on dialysis still experience disease progression, mainly because haemodialysis isn’t capable of removing all uremic solutes. Dialytic clearance is limited due to protein binding and only unbound solute can be filtered out during dialysis.
Post-transplantation challenges apart from rejection events
Kidney transplantation transforms the lives of patients with end-stage kidney failure. Receiving a fully functional organ offers a second chance at health, improving quality of life without the burden of dialysis and allowing patients to pursue dreams and activities that were out of reach due to their illness. Ensuring the long-term success of a transplant is a main challenge of the modern healthcare system. The challenging part arises once after the transplantation is done. Maintaining the function of the received organ and avoiding comorbidities could turn hope into uncertainty. Besides the risk that the body rejects the new kidney, transplant recipients are more likely to develop other conditions like diabetes and heart disease compared to the general population.
Chronic inflammation is a main contributor to kidney failure
Despite adequate therapy preventing the rejection events, in many cases, kidney failure occurs again, suggesting the inflammatory processes of chronic origin contribute to it. Taking into account the overall goal of the IMMEDIATE consortium exploring the diet-microbiome-metabolite-immune axis, we are aligning the same aim and hypotheses that chronic inflammation is a major driver of kidney failure in the post-transplantation period, as dietary and microbial metabolites affect the immune response.
Our research within the IMMEDIATE consortium focuses on the relationship between diet, metabolites produced by gut bacteria and the immune system. We believe that chronic inflammation, influenced by diet and gut microbiota, is a key factor in kidney failure after transplantation.
To explore this further, we use advanced technologies and tools to analyse clinical data and biological samples from one of the largest cohorts of transplant patients in the world, the KTx360° study. We also employ artificial intelligence to understand how health issues develop and vary among individuals after a transplant. Our goal is to identify inflammatory processes and markers that can predict negative outcomes in transplant patients, helping to improve their long-term health.