# Role of Kidney Proximal Tubular Secretion in Critical Illness

> **NIH NIH R01** · UNIVERSITY OF WASHINGTON · 2020 · $702,268

## Abstract

Project Abstract
Acute kidney injury (AKI) is one of the most common types of organ dysfunction among persons in the
intensive care unit (ICU). Most causes of AKI involve injury to the proximal tubules of the kidneys. However,
clinical evaluation of AKI relies on measurements of serum creatinine as a marker of glomerular filtration.
Consequently, the severity and clinical implications of AKI may be misaligned with the biology of the disease.
Proximal tubular secretory clearance is rarely measured due to a lack of reliable methods and uncertainty
regarding clinical interpretation. We developed a novel targeted mass spectrometric assay to estimate tubular
secretory clearance based on quantification of endogenous secretory solutes in plasma and urine, and we
demonstrated that tubular secretory clearance is associated with the progression of chronic kidney disease
and mortality independent of the estimated glomerular filtration rate.
The general goal of this application is to advance clinical assessment of AKI by adding functional
measurements that align with the underlying mechanisms of disease. We propose to measure tubular
secretory clearances in a prospective cohort of critically ill adults who are at high risk for developing AKI. We
will assess potential shared and unique risk factors for decline in tubular secretion and glomerular filtration,
determine whether tubular secretory clearance adds to the prediction of measured drug levels, and test
whether lower secretory clearance is associated with ICU delirium, coma and the severity and prognosis of
AKI.
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## Key facts

- **NIH application ID:** 9916616
- **Project number:** 1R01DK124063-01
- **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:** $702,268
- **Award type:** 1
- **Project period:** 2020-05-01 → 2024-04-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/9916616

## Citation

> US National Institutes of Health, RePORTER application 9916616, Role of Kidney Proximal Tubular Secretion in Critical Illness (1R01DK124063-01). Retrieved via AI Analytics 2026-05-23 from https://api.ai-analytics.org/grant/nih/9916616. Licensed CC0.

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