A simple blood test could reveal kidney disease earlier so more can be done to halt progression, while also allowing better ongoing management of kidney health by simpler monitoring.
Nearly a third of intensive care patients develop acute kidney injury, which is currently hard to detect in very early stages when intervention is critical.
Meanwhile, an estimated 13% of people are living with chronic kidney disease, which remains a leading cause of premature mortality.
Now, a team from RMIT University and Australian diagnostic company Nexsen Limited have signed a AUD $1.125 million research contract to develop point-of-care tests – based on their established platform technology – to identify acute kidney injury hours faster than current methods and to allow chronic kidney disease monitoring at home for the first time.
Kidney disease testing still an unmet clinical need
Director of RMIT's Sir Ian Potter NanoBioSensing Facility, Professor Vipul Bansal, said their test could provide a more timely, cheaper and easier alternative to existing pathology-based kidney function tests.
"The rapid onset of acute kidney injury – yet the lack of a reliable diagnostic test – poses a major challenge for healthcare professionals to make timely interventions," Bansal said
"The current testing of kidney damage based on reduced urine output and increased serum creatinine levels can take six and 24 hours respectively, while our ultrasensitive diagnostic technology aims to detect damage much earlier."
Earlier intervention can result in better outcomes and prevent acute kidney injury from developing into irreversible chronic kidney disease, he explained.
Professor Shekhar Kumta, a clinician experienced in managing kidney failure in trauma and complex surgical patients, and Head of the Clinical Translational Research Partnership between RMIT University and Northern Hospital, said current methods often delay diagnosis.
Detecting kidney injury currently relies on testing kidney function, such as their ability to filter out creatinine. However, as creatinine build-up takes time, it can take hours or days to detect a noticeable difference.
"Changes in the kidney function lag the damage to the complex structure of the kidney," Kumta explained.
"A new test that can directly investigate the damage to different parts of the kidneys will be a real game-changer."
To do this, the team is developing their patented DNA aptamers that detect specific biomarkers associated with structural kidney damage.
"These new blood tests will be able to diagnose the root cause of the acute kidney injury early, which will play an important role in more clearly defining the optimal clinical management plan for patients," Kumta said.
Similar tests customised for at-home regular monitoring of chronic kidney disease could help over 850 million patients worldwide, with the potential to sit alongside the blood glucose monitoring many diabetics use as part of their daily routine.
Established platform technology
RMIT has a significant relationship with Nexsen, with the two having signed an MOU defining the long-term strategic partnership terms, and with RMIT recently taking an equity position in the company.
The strength of this relationship is underscored by several joint appointments between RMIT and Nexsen, including Bansal's role as Chief Innovation Officer and Chair of the Advisory Board at Nexsen.
The team at RMIT's Sir Ian Potter NanoBioSensing Facility have strong capabilities in developing point-of-care biosensor technologies for a range of clinical targets and will be applying their established platform technology for kidney disease diagnosis.
This technology has already been well developed for another diagnostic target – Group B Streptococcus (GBS) bacteria – in another collaboration with Nexsen.
The test for GBS, which is carried by 1 in 5 pregnant women and can cause serious complications to babies, is progressing rapidly.
These investigational devices have been manufactured, and the clinical trial has been approved to begin this year at Northern Health in Melbourne, ahead of schedule.
Nexsen's Executive Chairman, Reece O'Connell, said both projects with RMIT would deliver rapid, affordable tests that can be used in hospitals, clinics, and ultimately in the home.
"Our first products are targeting key unmet clinical needs in globally significant markets such as GBS and kidney disease," O'Connell said.
"We're excited to continue our deep relationship with RMIT into the kidney disease project, where we are addressing one of the most pressing global health challenges, as chronic kidney disease becomes more and more prevalent in global communities."
