Tuttle KR. Protein kinase C-beta inhibition for diabetic kidney disease. Diabetic Res & Clin Practice 13:S70-S74,2008.

Amid the rapidly rising number of people with diabetes worldwide, the prevalence of diabetic kidney disease (DKD) is expected to increase considerably despite available treatments. Consequently, novel therapeutic agents are urgently needed. Ruboxistaurin mesylate is a bisindolylmaleimide that specifically inhibits the β isoform of protein kinase C (PKC). In experimental models of DKD, ruboxistaurin normalized glomerular hyperfiltration, decreased urinary albumin excretion, preserved kidney function, and reduced mesangial expansion, glomerulosclerosis, and tubulointerstitial fibrosis. These beneficial effects of ruboxistaurin, both alone and combined with renin-angiotensin system inhibition, have been observed in a variety of experimental models of DKD. A phase 2 study of PKC-β inhibition in persons with type 2 diabetes and DKD already treated with angiotensin converting enzyme inhibition and/or angiotensin receptor blockade has been conducted. Addition of ruboxistaurin for 1 year reduced urinary albumin, prevented an increase in urinary transforming growth factor-β, and stabilized estimated glomerular filtration rate. Based on secondary analyses of clinical trials in patients with diabetic retinopathy or neuropathy, ruboxistaurin appears safe and may also prevent onset of DKD. PKC-β inhibition holds promise as a new strategy to improve kidney disease outcomes in diabetes. Large-scale clinical trials will be required to confirm safety and to validate prospective benefits of ruboxistaurin on relevant clinical endpoints in DKD.

 

Link to On Line Article

 

Andrew S. Levey, MD, Daniel Cattran, MD, Aaron Friedman, MD, W. Greg Miller, PhD, John Sedor, MD, Katherine Tuttle, MD, Bertram Kasiske, MD, Thomas Hostetter, MD
American Journal of Kidney Diseases Volume 54, Issue 2, Pages 205-226

Changes in proteinuria have been suggested as a surrogate outcome for kidney disease progression to facilitate the conduct of clinical trials. This report summarizes a workshop sponsored by the National Kidney Foundation and US Food and Drug Administration (FDA) with the following goals: (1) to evaluate the strengths and limitations of criteria for assessment of proteinuria as a potential surrogate end point for clinical trials in chronic kidney disease (CKD), (2) to explore the strengths and limitations of available data for proteinuria as a potential surrogate end point, and (3) to delineate what more needs to be done to evaluate proteinuria as a potential surrogate end point. We review the importance of proteinuria in CKD, including the conceptual model for CKD, measurement of proteinuria and albuminuria, and epidemiological characteristics of albuminuria in the United States.

 

Providence Medical Research Center is currently participating in several clinical trials sponsored by the National Institutes of Health. We have been chosen to participate in these trials because of our excellent performance in clinical research. We are proud to be a part of advancing medical knowledge and improving patient care through research.
 

The Center for Maternal Fetal Medicine at Providence Sacred Heart Medical Center and Children's Hospital provides a wide spectrum of highly specialized diagnostic and therapeutic procedures to monitor pregnancy from conception through delivery. As part of their efforts to stay on the cutting edge of practice, our physicians participate in research trials.

Sacred Heart Perinatologists Dr. Reinaldo Acosta and Dr. Jorge Tolosa have been chosen as investigators in perinatal research by the National Institute of Child Health and Human Development (NICHD) Maternal Fetal Medicine Units (MFMU) Network.

The NICHD is one of the Institutes within the National Institutes of Health (NIH). In 1986, the NICHD created the MFMU Network to focus on clinical questions in maternal fetal medicine, particularly with respect to the continuing problems of preterm birth, low birth weight, and medical problems of pregnancy. Operating under cooperative agreements, the current Network is comprised of fourteen university-based clinical centers and a data coordinating center. Since its creation, the MFMU Network has been a driving influence for introducing new scientific discoveries into the field of perinatology. More than 30 randomized clinical trials, cohort studies and registries have been completed or are in progress. The studies to date have not only identified new therapies and evaluated technologies used in maternal-fetal medicine, but also have helped to abolish practices that are not useful.

Click here to visit the Center for Maternal Fetal Medicine Web page.

 

Providence Medical Research Center is the only physician-led, full-spectrum medical research center in the Inland Northwest. The program truly lives up to the "bench-to-bedside-to-community" paradigm. We conduct research at many levels.

• Multi-center clinical trials in multiple specialties
• Original, investigator-initiated studies
• Pharmacokinetic and pharmacodynamic studies
• Physiology studies
• Cellular and molecular biology

 

Should Albuminuria Be a Focus of Antihypertensive Therapy Goals?
Radica Z. Alicic, MD, Sandeep A. Saha, MD, Robert A. Short, PhD, and Katherine R. Tuttle, MD
Current Hypertension Reports 2009, 11:354-362
Albuminuria has been recognized as a risk marker for both chronic kidney disease and cardiovascular disease in large observational cohorts. In addition, post hoc analyses of many large randomized trials have found a positive relationship between albu­minuria and adverse renal and cardiovascular outcomes, leading some to suggest that albuminuria may be a potential therapeutic target for antihypertensive treatment. However, direct clinical evidence linking albuminuria reduction to reduction in adverse renal and cardiovascular events is scarce.  (Abstract on line)

 

Walk more, eat well, and you'll live longer.

It's a simple premise, but it's the foundation of the "Start!" movement, from the American Heart Association (AHA).  Research has shown that you can gain about two hours of life for every hour of regular vigorous exercise you do. You couldn't find a better two-for-one deal if you tried!

It's a good thing, too. The American workforce is becoming more and more sedentary. As a result, our waistbands are growing. So are our healthcare costs and the number of preventable illnesses.

Start! is here to stop the trend. Walking is simply the first step toward a healthier lifestyle.

So join the Start! Movement. Check out the AHA free tools on-line to motivate more Americans to Start! walking:

The Start! movement is here to motivate and encourage all Americans to take up walking and other healthy habits as part of their daily routine all year round, and to live longer, stronger, heart-healthy lives.

April 8^th is National Start! Walking Day, we challenge you to join the nationwide campaign to get Americans walking! The goal  of The American Heart Association is to walk a million steps and raise $1 million.

The AHA Challenge for You! 

• Start! by getting out and taking a WALK
• Then take 30 minutes to inspire your friends and family by sending them an email. 
• Encorage them to take a WALK and join you in raising funds to fight our nation's No. 1 and No. 3 killers -heart disease and stroke.
  

 Find Out More  

 

 

Katherine R. Tuttle, MD; Joan E. Milton, MS, RD, CD  Arch Intern Med. 2009;169(11):1027

 

Our annual report provides a summary of research done at Providence Medical Research Center, along with publications, speaking engagements, and other activities and areas of service to our community.