Dr. Oleh Akchurin Awarded Grant to Identify Novel Actionable Drivers of Anemia in Children with Chronic Kidney Disease

Oleh Akchurin, M.D., Ph.D., Assistant Professor of Pediatrics and Associate Director of the Physician Scientist Training Program in Pediatrics has received funding for his study, “Role of myeloid cells in the pathophysiology of anemia in children with chronic kidney disease” from the Sy Syms Foundation and Van Pelt/Bass Foundation.

Macrophages are known to play a major role in iron metabolism, as evident from non-kidney related pre-clinical and patient-oriented studies. At the same time, disruptions in iron metabolism play a critical role in the development of anemia in children with chronic kidney disease (CKD).  However, the role of macrophages, and their precursors, monocytes, in the development of anemia in children with CKD remains poorly understood. In this study, stemming from his previous work, Dr. Akchurin will test how the changes in monocyte/macrophage behavior in CKD affect the production and survival of red blood cells. His research team will specifically focus on the function of ferritin in macrophages in monocytes.

Chronic kidney disease is a major public health problem that imposes a significant financial burden. Anemia, a major CKD comorbidity, negatively affects physical growth and neurocognitive development, and leads to school absenteeism, poor academic performance, and also correlates with poor cardiovascular outcomes. Iron supplementation is the leading therapeutic modality in children with mild to moderate CKD while erythropoietin therapy is used about 3 times less frequently in children with early CKD stages. However, significant concerns about iron toxicity and efficacy remain unanswered. Serum ferritin is used as the biomarker of iron stores in patients although its cellular source and relationship to anemia remain unclear. Although current guidelines recommend the repletion of iron stores in children with CKD, serum ferritin, which is traditionally considered a marker of iron stores, has shown to correlate inversely with hemoglobin in CKD children. Macrophages appear to be the primary cell type producing serum ferritin. Therefore, delineating the role of macrophages and monocytes in the pathogenesis of anemia in children with CKD is critical.  Dr. Akchurin’s study aims to advance our understanding of anemia in CKD, regulation of functional iron stores, and by doing so set the stage for the identification of novel treatment targets and development of successful therapies, to ultimately improve outcomes in children with CKD.

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