# Kidney Tubular Functions in Type 1 Diabetes

> **NIH NIH R01** · UNIVERSITY OF WASHINGTON · 2020 · $722,130

## Abstract

ABSTRACT
Chronic kidney disease is a common and serious complication of type 1 diabetes (T1D). Historically, diabetes
has been viewed as a primary glomerular kidney disorder based on classic pathological features. However,
diabetes also promotes injury to kidney tubular epithelial cells and their microenvironment through increased
work of glucose reabsorption and direct stimulation of pro-inflammatory and pro-fibrotic pathways. Sodium
glucose co-transporter-2 inhibitors, which block glucose entry into proximal tubular cells, are the most
promising new treatment for slowing the progression of kidney disease in type 2 diabetes.
Compelling mechanisms of kidney tubular injury in diabetes have been incompletely translated into human
disease, impeding new strategies for monitoring and treatment. The goal of this proposal is to advance
understanding of the evolution, determinants, and clinical consequences of kidney tubular functions in persons
with type I diabetes (T1D). We will add novel measurements of tubular functions and damage to two landmark
clinical trials of T1D spanning the course of kidney disease. Through these measurements, we will for the first
time characterize the natural history of tubular functions over time in T1D, identify potential risk factors for the
loss of tubular functions, and test whether measures of tubular functions and damage are associated with
metabolic complications, changes in key pathologic features, and a decline in glomerular kidney functions. The
construction of a detailed natural history of kidney tubular functions in T1D will lay needed groundwork for the
future development of new interventions to improve prevention, monitoring, and treatment.

## Key facts

- **NIH application ID:** 10142841
- **Project number:** 1R01DK125084-01A1
- **Recipient organization:** UNIVERSITY OF WASHINGTON
- **Principal Investigator:** BRYAN R KESTENBAUM
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2020
- **Award amount:** $722,130
- **Award type:** 1
- **Project period:** 2020-09-15 → 2024-06-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10142841

## Citation

> US National Institutes of Health, RePORTER application 10142841, Kidney Tubular Functions in Type 1 Diabetes (1R01DK125084-01A1). Retrieved via AI Analytics 2026-05-23 from https://api.ai-analytics.org/grant/nih/10142841. Licensed CC0.

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