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Mechanisms of Maternal Renal and Gestational Dysfunction Following Recovered Acute Kidney Injury

Award Number: K01DK140521
ORGANIZATION: NATIONAL INSTITUTE OF DIABETES & DIGESTIVE & KIDNEY DISEASES
OPDIV: NIH
AWARD CLASS: DISCRETIONARY
AWARD ACTIVITY TYPE: TRAINING/TRAINEESHIP
PERIOD OF PERFORMANCE START DATE: 04/01/2026
PERIOD OF PERFORMANCE END DATE: 03/31/2031

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Mechanisms of Maternal Renal and Gestational Dysfunction Following Recovered Acute Kidney Injury - PROJECT SUMMARY Acute kidney injury (AKI), defined by sudden onset renal cell injury and functional impairment, occurs in up to 15% of hospitalizations and 60% of critically ill patients. AKI also damages other organs, including the brain, lungs, and cardiovascular system, and can become lifelong chronic kidney disease (CKD). There is currently only one clinically approved treatment for AKI: aggressive fluid resuscitation immediately following injury. Pregnancy causes stress on maternal organs to grow a fetus, including providing blood supply. The kidney is critical to this process as it controls vascular tone and blood pressure through the renin-angiotensin system. Available data suggest women with recovered AKI are at risk for adverse maternal and fetal outcomes, including preterm birth and fetal growth restriction, which are linked to later disease in the offspring; this underlies the importance of a mechanistic understanding of this long-term outcome of AKI. As people of childbearing age experience a lifelong risk of reproductive and renal complications, the increase in AKI in this population mandates investigation. We hypothesize that recovered rhabdomyolysis- induced AKI (RIAKI) causes quantifiable intrarenal renin-angiotensin system (RAS) alterations in pregnancy, leading to gestational complications, placental insufficiency, and later maternal renal dysfunction. This hypothesis will be tested using an in vivo mouse model of RIAKI, a form of AKI observed in young people from muscle injury sustained during exercise, combat, and accidents; therefore, this is a relevant model to study the long-term impact of recovered AKI on people of childbearing age. Aim 1 will determine whether maternal recovered RIAKI alone is sufficient to result in dysfunctional pregnancy—versus including paternal and fetal effects in the model—by natural breeding and implanting embryos from non-procedure mice into RIAKI dams and comparing maternal outcomes to shams. We will also test a drug, cilastatin, administered at injury to determine if post-AKI pregnancy complications are improved. In Aim 2, the intra-renal mechanisms in recovered RIAKI dams regulating vascular control in pregnancy will be assessed for postpartum maternal outcomes by modifying renal ACE2, a critical component of the renal renin-angiotensin system. In Aim 3, maternal urinary biomarkers will be identified at clinically relevant postpartum time points to diagnose maternal renal disease early and provide new therapeutic targets. This career development proposal contains a comprehensive training plan to strengthen existing scientific competency and develop career-long collaborations. The K01 will apply existing reproductive expertise to a new question with significant translational impact, supporting the applicant in becoming an independent investigator of the links between renal, reproductive, and developmental pathology. Ultimately, these studies are designed to understand the risks of AKI on reproductive outcomes and develop novel interventional strategies to prevent long-term disease in parents and offspring.


Issue Date FY	Funding FY	Legal Entity Name	Legal Entity Address	Legal Entity City	Legal Entity State	Legal Entity Zip Code	Legal Entity COUNTY	Legal Entity COUNTRY	Assistance Listing	Award Code	Budget Year	Action Date	Action Type	Action Amount

Issue Date FY: 2026 ( Subtotal = $164,745 )
2026	2026	OREGON HEALTH & SCIENCE UNIVERSITY	3181 SW SAM JACKSON PARK RD	PORTLAND	OR	97239	MULTNOMAH	USA	Diabetes, Digestive, and Kidney Diseases Extramural Research	000	1	3/19/2026	NEW	$164,745
														Subtotal = $164,745

Grand Total All Awards = $164,745

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Mechanisms of Maternal Renal and Gestational Dysfunction Following Recovered Acute Kidney Injury

Award Number: K01DK140521

ORGANIZATION: NATIONAL INSTITUTE OF DIABETES & DIGESTIVE & KIDNEY DISEASES

OPDIV: NIH

AWARD CLASS: DISCRETIONARY

AWARD ACTIVITY TYPE: TRAINING/TRAINEESHIP

PERIOD OF PERFORMANCE START DATE: 04/01/2026

PERIOD OF PERFORMANCE END DATE: 03/31/2031

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