Researchers from Johns Hopkins Medicine and multiple institutions around the world have compiled the first kidney atlas, which will facilitate research regarding early detection and improved treatment options for kidney disease. 

Conditions such as acute kidney injury (AKI), chronic kidney disease (CKD) and kidney failure are global concerns, and experts believe that a more in-depth look at the cellular make-up of damaged kidneys will serve as an important resource for researchers and clinicians who study kidney health. Publication of the atlas opens the door for a better understanding of how kidney injury and disease develop, and it may lead to the design of treatments and detection tools to improve kidney health.

According to the Centers for Disease Control and Prevention, chronic kidney disease affects about 14% of the U.S population.

The kidney atlas was constructed by studying 93 reference kidneys (45 biopsies from healthy donor kidneys and 48 biopsies from diseased donor kidneys) and was published July 19 in the Journal Nature. The Johns Hopkins Medicine nephrology division contributed biopsies from tissues with acute kidney injury, a common complication in hospitalized patients. This study is part of the national landmark Kidney Precision Medicine Project funded by the National Institutes of Health.

All told, the atlas comprises molecular and cellular “maps” of 51 main kidney cell types, including some rare ones; 28 kidney cellular states; basic genetic information, and dynamic models of cells and their “relationships” to their biological environments.

Human kidneys have vital roles in the preservation of body fluid balance, metabolic waste removal and blood pressure maintenance. After an injury, changes occur that impact their performance. “The balance between successful or unsuccessful repair processes may ultimately contribute to the progressive decline in kidney function. Defining the cellular and molecular characteristics of the kidney at an individual cell level is key to revealing essential clues to how people develop acute and chronic kidney problems,” says Chirag Parikh, M.B.B.S., Ph.D., professor of medicine and director of the Division of Nephrology at Johns Hopkins Medicine and site investigator for the study.

To ensure the team examined a number of cell state profiles, they used healthy reference tissues obtained from multiple sources, and biopsies were collected from patients with AKI and CKD under rigorous quality assurance and control procedures, the researchers say. The atlas defines in unprecedented detail both healthy and altered states across various regions of the organ, and identifies related gene expression and other factors associated with worsening kidney function.

With dialysis and kidney transplant surgery being the only available treatments for kidney failure, early detection becomes increasingly important considering a person’s quality of life prognosis and preventing potential kidney loss. This groundbreaking kidney atlas allows for identification of novel biological pathways, cellular states and proteins for drug discovery in kidney disease for an easier pathway toward early diagnosis.