Top kidney disease research advancements from 2024

With so much happening throughout the year, you may have missed some big headlines from the nephrology (kidney) research field in 2024. Fortunately, the American Kidney Fund (AKF) has been keeping track – and has rounded up some of the biggest pieces of news from the year for you. From new potential kidney donor options to better understandings of diagnosing kidney disease, it has been another big year for kidney disease research!

Here are nine of the biggest headlines from the nephrology research field from 2024.

#1 - Northwestern Medicine surgeons perform awake kidney transplant with next day discharge

On June 24, Northwestern Medicine performed its first awake kidney transplant surgery. The patient was John Nicholas, who received a new kidney from his childhood best friend, Pat Wise. John did not receive general anesthesia (which puts a person to sleep and manages their pain during a surgery) and instead got a shot in his spine to numb him from the waist down. He was able to go home less than 24 hours after his surgery, when in-hospital recovery normally takes between two and three days. "Not only can awake kidney transplantation help patients who have risks or phobias to general anesthesia, but it can help shorten their hospital stay so they can recover more comfortably at home," said Dr. Vincente Garcia Tomas, anesthesiologist and chief of regional anesthesiology and acute pain medicine at Northwestern Memorial Hospital.

#2 - Kidney donation seen as 'safe and getting safer' 

According to a study published in JAMA in August, the number of U.S. adults who died within 90 days of donating a kidney significantly dropped in the past decade. Between 1993 and 2012, there were about three deaths out of every 10,000 donors. Between 2013 and 2022, there was less than one death out of every 10,000 donors. "We have long known kidney donation is safe, but our findings suggest that mortality among donors is rare, and the procedure is safer than ever before," said Macey L. Levan, JD, PhD, associate professor of surgery and population health and director of the Center for Surgical and Transplant Applied Research Qualitative Core at NYU Langone Health and vice president of patient and donor affairs for the Organ Procurement and Transplantation Network.

#3 - World's First Genetically-Edited Pig Kidney Transplant into Living Recipient Performed at Massachusetts General Hospital

On March 16, Massachusetts General Hospital performed the first kidney transplant of a genetically-modified pig kidney into a living person. Rick Slayman, age 62, received the kidney. He had previously had a transplant from a deceased donor, but it began failing and he resumed dialysis in May 2023. After receiving the pig kidney transplant, Rick went home from the hospital on April 3. Sadly, Rick died in early May, about two months after the transplant. However, researchers noted that the cause of death was cardiac arrest (a heart attack) and was not related to his body rejecting the kidney. 

In 2023, a pig kidney was transplanted into a brain-dead patient, but this was the first time a pig kidney had been transplanted into a living patient. Additionally, a 54-year-old woman in New Jersey named Lisa Pisano received a pig kidney and heart transplant in April, but it was removed 47 days after the surgery because the organ was failing. Most recently, Towana Looney, age 53, from Alabama received the third gene-edited pig kidney at NYU Langone on Nov. 25. She was discharged from the hospital 11 days later and at the time of the publication of this blog post, is doing well. 

Researchers said these surgeries show the promise of xenotransplantation – transplanting organs or tissues from one species into another – as a possible solution to the organ shortage.

#4 - New research supports expansion of kidney donation to include organs from deceased patients who once had dialysis

In a study published in JAMA on May 23, researchers from Johns Hopkins Medicine found that kidneys from deceased donors who received dialysis due to a severe acute kidney injury (AKI) around the time of death could still be used for transplant. The study found that there was a delay in the recipient's body's response to the kidneys, but there was no significant difference in the rates of transplant failures or in patient deaths. Right now, more than 1 in 5 of deceased donor kidneys are not used because they had been exposed to dialysis after an AKI. This study shows that this could be a possible way to expand the pool of available kidneys for transplant – ultimately saving more lives.

#5 - Examining the Safety and Efficacy of Semaglutide in Nondiabetic CKD

During the American Society of Nephrology (ASN) 2024 conference, researchers shared an update on the use of semaglutide (a type of glucagon-like peptide-1 (GLP-1) drug) for people living with kidney disease. For people with obesity/overweight with kidney disease who are not also living with diabetes, semaglutide was still an effective treatment to reduce proteinuria, which is protein in your urine. After 24 weeks of using semaglutide, patients' UACR (albumin-to-creatinine ratio) results on average dropped over 50% - meaning they had half as much protein in their urine compared to when they started the trial. The study did not show any change in estimated glomerular filtration rate (eGFR) between the group taking semaglutide and the group not taking it. 

In a previous study, semaglutide helped slow progression of kidney disease and reduced the risk of death from kidney disease or heart disease for people living with diabetic kidney disease.  It has been approved as a treatment for diabetic kidney disease, but this research presented at ASN 2024 showed it could also help treat kidney disease in people who do not also have diabetes. 

#6 - Kidney transplantation between donors and recipients with HIV is safe

In a study led by Johns Hopkins Medicine, researchers found that kidney transplants between donors and recipients who both have HIV were safe. They compared the rates of organ rejection, graft failures and death between recipients whose donor had HIV versus donors without HIV over the course of three years. The researchers found that the rates of all three post-transplant events (organ rejection, graft failures and death) were about the same between the groups. This means that transplants with donors with HIV are just as safe as those from donors without HIV. 

Currently, transplants for people with HIV are only allowed to be done in a research setting, but this study shows that it may be possible to change this rule and expand the pool of kidney donors.

#7 - APOL1 Bi- and Monoallelic Variants and Chronic Kidney Disease in West Africans

Researchers looked at the connection between kidney disease and APOL-1 genetic mutations in this study. The patients involved were from Ghana and Nigeria. They compared two groups of patients: one had stages 2-5 kidney disease with biopsy-proven glomerular disease and the other group did not have kidney disease. They looked at how many people within each group had a genetic mutation in one APOL-1 gene, had a genetic mutation in both APOL-1 genes or had no APOL-1 genetic mutations. The researchers found that people with one APOL-1 genetic mutation were associated with 18% higher odds of kidney disease and 61% higher odds for focal segmental glomerulosclerosis (FSGS). People with a genetic mutation in both APOL-1 genes were associated with 25% higher odds of CKD and 84% higher odds of FSGS. The study shows a clear association between kidney disease and APOL-1 genetic mutations. Find out more about APOL-1 mediated kidney disease (AMKD) and save the date for AMKD Awareness Day on April 29.

#8 - Kidney Biopsy Findings Among Patients With Diabetes in the Cleveland Clinic Kidney Biopsy Epidemiology Project

This study did kidney biopsies on patients with diabetic kidney disease (DKD) and found that more than half of the patients had a type of kidney disease other than DKD. Some of the most common diagnoses were FSGS, IgA nephropathy, lupus and ANCA. The results of this study may mean that many people with DKD are misdiagnosed and, therefore, not receiving the best treatment options for their kidney disease. Find out more about the importance of getting an accurate diagnosis on our Know Your Cause pathway.

#9 - A breakthrough for lupus treatment? Study explores CAR T-cell therapy for autoimmune disease

Researchers at nine institutions worldwide, including University of California Davis Health, announced a clinical trial to test a treatment option for patients with lupus or lupus nephritis. 

The treatment is called chimeric antigen receptors (CAR) T-cell therapy. For cancer patients, T cells – which are cells involved in the immune system (your body's defense against sickness) – are taken from a patient through a blood draw. Then the CARs are "coded" to tell the T cells what cells in the body they should attack. For cancer patients, the CARs tell the T cells to attack tumors or cancer cells. 

This study is testing to see if a specific CAR called CABA-201 can be used to tell T cells to attack another kind of immune cell that produces antibodies called a B cell. For patients with lupus or lupus nephritis, the B cell attacks healthy tissue by mistake. Using the same idea as the CART T-cell therapy, the CABA-201 would be coded to stop these incorrect B cell attacks, reducing symptoms and damage caused by lupus or lupus nephritis. 

You can find more headlines from throughout the year on our Renal news round up page or by signing up to receive our KidneyPro SmartBrief newsletter.

We hope to see even more progress in the kidney disease research and treatment space in 2025!