African-Americans are four times more likely to experience chronic kidney disease and failure than Caucasians. Kidney transplants have more than doubled in recipients above 65 years of age from 2000-08. And the prevalence of end-stage renal disease, or kidney failure, in the United States has continued to increase, particularly among elderly patients and African-Americans. These statistics are according to the National Institutes of Health. Despite knowledge of the disparity, researchers and clinicians are seeking a new understanding of why the age and race gap exists.
A new study led by Dr. Kathleen Tornatore, professor in the Department of Pharmacy Practice at the University at Buffalo School of Pharmacy and Pharmaceutical Sciences, aims to answer these questions by exploring the effects of age, race and sex on immunosuppressive medication and immune responses of renal transplant patients. Funded by a five-year, $3.5 million grant from the National Institutes of Aging, the study aims to bridge the gap between current, non-specific clinical methods and personalized medicine for high-risk patients.
Personalized Dosing Regimens Could Improve Response
The project addresses a prime goal of the UB Clinical and Translational Science Institute to increase research and address health disparities in Western New York. This study will be conducted between Erie County Medical Center and the Clinical and Translational Research Center and utilize core resources available to clinical investigators.
The study will recruit more than 200 black and white, male and female kidney transplant recipients of varying ages from the Regional Center of Excellence for Transplantation and Kidney Care at the Erie County Medical Center. “This study will address the lack of clinical scientific knowledge that combines age, race and sex influences to personalize dosing regimens of immunosuppressive medications after kidney transplant, and may improve patients’ responses contributing to long-term transplant survival,” said Tornatore, also director of the UB Transplantation Immunosuppressive Pharmacology Research Program.
The disease—which has no symptoms in its early stages—is responsible for more deaths each year than breast or prostate cancer, according to the National Institute of Diabetes and Digestive and Kidney Diseases. Kidney transplants are the preferred method of treatment over dialysis for kidney failure due to its cost efficiency and improved life expectancy of patients, but are less successful among black patients.
For the transplant to succeed, patients receive prescription medicine for long-term immunosuppression to prevent their body’s immune system from attacking, or rejecting, the foreign organ. Increased age is a risk for rejection and suggests the need for age-adjusted dosing regimens of immunosuppressive medications, said Tornatore. Survival of the kidney transplant is also poorer in African-Americans than Caucasians, which may be due to a variety of racial and age-related differences.
Additional investigators include Dr. Rocco Venuto, professor in the Jacobs School of Medicine and Biomedical Sciences at UB; Dr. Gregory Wilding, professor and chair of the Department of Biostatistics in the UB School of Public Health and Health Professions; Dr. Donald Mager, professor and vice chair of the Department of Pharmaceutical Sciences in the School of Pharmacy and Pharmaceutical Sciences; Dr. Kris Attwood, research assistant professor in the Department of Biostatistics and associate director of the Biostatics Shared Resource at Roswell Park Comprehensive Cancer Center; Dr. Hans Minderman, assistant professor of oncology in the Jacobs School of Medicine and Biomedical Sciences and associate director of the Flow and Image Cytometry Facility at Roswell Park Comprehensive Cancer Center; Dr. Donald Yergeau, associate director of genomic technologies of the UB Genomics and Bioinformatics Core; and Dr. Daniel Brazeau, associate professor in the Joan C. Edwards School of Medicine at Marshall University.
Reprinted with permission from the University at Buffalo School of Pharmacy and Pharmaceutical Sciences.