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A novel tool for predicting disease progression and treatment response in nephrotic syndrome

04 December 2023

Dr Samantha Hayward from the University of Bristol has been awarded a Paediatric Start-up grant of £30,000 to develop a tool which will help personalise treatment for children with nephrotic syndrome.

The problem

Nephrotic syndrome is a condition where the kidneys leak large amounts of protein from the blood into the urine. This can cause symptoms including swelling, especially of the legs and feet, and result in damage to the kidneys. It can also increase the risk of infections and blood clots.  

Currently patients are treated with steroids, however, these come with significant side effects. Some patients with nephrotic syndrome respond well to steroid treatment, whereas others do not respond and can go on to develop kidney failure. At the moment, doctors do not have a way of accurately predicting which patients will respond, so all patients receive the same treatment. 

A lady with blonde bobbed hair, black glasses and a black jumper with her arms folded, smiling to the camera.
Dr Samantha Hayward

The solution

Samantha and her team have discovered that a chemical tag on a patient’s DNA (genetic code) can be used to predict which patients with nephrotic syndrome will respond to steroid treatment. They have created a tool using this chemical tag information and cutting-edge computer science (machine learning) that can predict with 86% accuracy the people with nephrotic syndrome who respond to steroid treatment. However, the team do not know whether starting steroid treatment alters these chemical tags. This is important information as it would determine whether the tool could be used for patients who have already started treatment. 

In this project, Samantha will investigate whether steroids change the chemical tag on patients’ DNA and will use this information to update the prediction tool. This will make sure that the tool can accurately predict responses to treatment regardless of how much steroid treatment a patient has already received. 

What might this mean for patients?

This tool will enable more personalised treatment and advice for children with nephrotic syndrome. 

“Our aim is to personalise nephrotic syndrome treatment, so that patients can avoid medications that don’t work for them. Our research has identified that the chemical tags on a patient’s genetic code (DNA methylation) can indicate whether they respond to steroid treatment or not. Thanks to this Kidney Research UK paediatric start-up grant, we will now explore whether starting steroid treatment alters these chemical tags. This will allow us to determine if all nephrotic syndrome patients can benefit from our findings, regardless of whether they have had any steroid treatment previously or not. This is a crucial and exciting step forward for our research.” Dr Samantha Hayward

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