APRIL 6, 2005 | Female hormones could be a factor in the long-term survival rate for transplanted kidneys, according to a clinical trial to be conducted by the University of Arkansas for Medical Sciences (UAMS).

Jayant Kumar, M.D., assistant professor of internal medicine and nephrology in the UAMS College of Medicine, has received a $10,000 Chastain Research Grant from the National Kidney Foundation of Arkansas to determine if raloxifene – a prescription medication approved for the prevention and treatment of osteoporosis in women after menopause – could be beneficial to female kidney transplant patients. Raloxifene imitates some of the female hormone estrogen’s good effects without increasing the risk of cancer.

The Chastain Research Grant is given to area nephrologists who are working to improve the lives of kidney patients in Arkansas and throughout the world. The grant is named for J.D. Chastain, an Arkansas businessman and philanthropist who spearheaded an annual black-tie fundraiser for the National Kidney Foundation.

The survival rate of a transplanted kidney is about 12 years for a kidney harvested from an organ donor who died from trauma and 15 years or more for one donated by a blood-related family member. It has been noted that kidney diseases progress at a slower rate in women. Kumar said that eventually the kidneys become fibrous and atrophy. Once that happens, transplant patients must go on dialysis and be put back on the list for another transplant.

“We’ve noticed for some time that women with kidney diseases tend to have a longer survival rate of the kidney function than men. If we can determine if and how female hormones protect the kidneys, it could greatly enhance our ability to protect transplanted organs in the future,” said Kumar.

He said the secret could be that estrogen can protect the body from oxidizing chemicals that break down tissue.  Kumar will be measuring oxidant byproducts in the urine that could indicate damage to kidneys and determine if there are fewer byproducts when patients take the raloxifene.

The patients in the UAMS clinical trial, all postmenopausal women, will take raloxifene for one year to determine if the amount of oxidative stress marker in their urine decreases. If results from the study are significant, Kumar said a nation-wide clinical study could follow.

The science behind kidney transplantation has improved dramatically since it was first tried unsuccessfully in 1933. “In the past, researchers were working to put out the fire of acute organ rejection,” Kumar said, “but now we’ve gone to the next stage of working to give our patients longer, better quality lives.”

Unfortunately, the advances in science have not kept up with the increase in the number of Americans with kidney disease. According to the National Kidney Foundation, more than 20 million Americans – one in nine adults – have chronic kidney disease. Another 20 million are at increased risk for developing kidney disease, and most don't even know it.

“Kidney disease touches the lives of one out of every nine Americans, which is why we recognize March as National Kidney Month,” said Holly Whitcombe, executive director of the foundation’s Arkansas affiliate. Whitcombe added that there are more than 400,000 Americans on dialysis, including more than 22,000 who have had kidney transplants that are failing. About 60,000 Americans are waiting to receive kidney transplants.

UAMS is the state’s only comprehensive academic health center, with five colleges, a graduate school, a medical center, five centers of excellence and a statewide network of regional centers. UAMS has more than 2,200 students and 660 residents and is the state’s largest public employer with almost 9,000 employees. UAMS and its affiliates have an economic impact in Arkansas of $4.1 billion a year.

UAMS centers of excellence are the Arkansas Cancer Research Center, Harvey and Bernice Jones Eye Institute, Donald W. Reynolds Institute on Aging, Myeloma Institute for Research and Therapy and Jackson T. Stephens Spine and Neurosciences Institute. 

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National Kidney Foundation: http://www.kidney.org/

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