(Vienna, 17 June 2019) Having won several awards, dialysis research at MedUni Vienna has confirmed its position as a global leader in the field. For example, Rebecca Herzog was presented with the Stanley Shaldon Young Investigator Prize at the 56th Congress of the European Renal Association (ERA) and European Dialysis and Transplant Association (EDTA) in Budapest.
Rebecca Herzog is a postdoc researcher at the Christian Doppler Laboratory for Molecular Stress Research in Peritoneal Dialysis (CDL-MSRPD) located at MedUni Vienna. She has also recently won the Best Basic Science Prize awarded by the European Society for Peritoneal Dialysis (EURO-PD) for her lecture on a new cytoprotective additive being worked on at the CDL-MSRPD. Rebecca Herzog is receiving the Stanley Shaldon Prize for her papers on the mode of action of alanyl-glutamine (a dipeptide) as an additive in peritoneal dialysis, which, amongst other things, identified the relevance of a specific protein modification. Since she started out on her scientific career, Rebecca Herzog has focussed on peritoneal pathomechanisms and protective options during this form of renal replacement therapy, latterly with increasing use of systems biology methods. The translational studies were published in prestigious nephrology journals (Herzog et al., JASN 2014) and also in the field of proteomics and multi-disciplinary research (Herzog et al., Sci Rep 2017 & Mol Cell Proteomics 2018).
The recent highlight of the joint research at MedUni Vienna is a successful Phase II trial on the use of alanyl-glutamine in peritoneal dialysis fluids, for which Andreas Vychytil from MedUni Vienna's Division of Nephrology and Dialysis already won the Best Abstract Award at the Annual Dialysis Conference (ADC), as well as a keynote invitation to the World Peritoneal Dialysis Congress (Vychytil et al., "A randomized controlled trial of alanyl-glutamine supplementation in peritoneal dialysis fluid to assess impact on biomarkers of peritoneal health." Kidney Int 2018, dx.doi.org/10.1016/j.kint.2018.08.031
Leading innovator in peritoneal dialysis
MedUni Vienna's innovative research in the field of peritoneal dialysis is based on a close collaboration between the peritoneal dialysis area at the Division of Nephrology and Dialysis (Head: Rainer Oberbauer) and the Christian Doppler Laboratory for Molecular Stress Research in Peritoneal Dialysis at the Division of Pediatric Nephrology and Gastroenterology (Head: Christoph Aufricht).
This led to the world’s only successful clinical trial (Phase II) in the field of peritoneal dialysis being conducted at MedUni Vienna. After a while, regular peritoneal dialysis can cause the peritoneum to become "exhausted", if important endogenous protective mechanisms fail to counteract the negative impact of dialysis fluids. The study, led by Andreas Vychytil, shows that supplementing a new type of peritoneal dialysis solution with the active ingredient alanyl-glutamine counteracts the damage to the cells of the abdominal cavity caused by the dialysis solution, thereby potentially prolonging the survival time of peritoneal dialysis. Further promising clinical trials on the use of new substances to increase this protective mechanism are already being prepared in collaboration with CDL-MSRPD's commercial partner, Zytoprotec GmbH.
Advantages of peritoneal dialysis
One of the main functions of the kidneys is to filter metabolic products out of the blood. If the kidneys are no longer able to do this, the blood has to be artificially purified and drained of excess fluid by means of dialysis. Around 5,000 people in Austria are currently affected. Around 10% of these patients use the flexible method of peritoneal dialysis, in which the peritoneal membrane is used as a filter. Andreas Vychytil explains its advantages over conventional dialysis: peritoneal dialysis can be done at home, gives patients more flexibility and can significantly improve their quality-of-life. The vessel-friendly technique of eliminating excess water and dissolved uraemic toxins often helps to preserve any existing residual kidney function better than haemodialysis. However, the solutions that are used in peritoneal dialysis are still far from ideal. This is precisely what the MedUni Vienna group is addressing in its research. Innovative solutions should reduce the risk of infection and preserve the peritoneum for as long as possible, to give patients as normal a life as possible and/or to provide waiting time for a kidney transplant.
Joint EU project
MedUni Vienna is participating in an EU-funded (Horizon 2020 ITN) research project in the field of peritoneal dialysis. The international training network (ITN) known as "IMPROVE-PD" is funding a total of 15 research posts for PhD students in leading European centres. Four of these posts are at MedUni Vienna and are funded by industrial partners. Klaus Kratochwill, Head of the Christian Doppler Laboratory and leader of the "Treat" work package, which directly targets the development of new treatment options and solutions within the IMPROVE-PD project, outlines the advantages of this research network: "In the IMPROVE-PD project, leading European peritoneal dialysis research groups are tackling important clinical problems, in particular the risk of cardiovascular complications in dialysis patients. The EU project is a primary focus for international research into life-maintaining peritoneal dialysis, with MedUni Vienna being a model location for the integration of translational research and innovative product development."
• Herzog, R., T. O. Bender, A. Vychytil, K. Bialas, C. Aufricht and K. Kratochwill (2014). "Dynamic O-linked N-acetylglucosamine modification of proteins affects stress responses and survival of mesothelial cells exposed to peritoneal dialysis fluids." J Am Soc Nephrol 25(12): 2778-2788. dx.doi.org/10.1681/ASN.2013101128
• Herzog, R., L. Kuster, J. Becker, T. Gluexam, D. Pils, A. Spittler, M. K. Bhasin, S. L. Alper, A. Vychytil, C. Aufricht and K. Kratochwill (2017). "Functional and Transcriptomic Characterization of Peritoneal Immune-Modulation by Addition of Alanyl-Glutamine to Dialysis Fluid." Sci Rep 7(1): 6229. dx.doi.org/10.1038/s41598-017-05872-2
• Herzog, R., M. Boehm, M. Unterwurzacher, A. Wagner, K. Parapatics, P. Majek, A. C. Mueller, A. Lichtenauer, K. L. Bennett, S. L. Alper, A. Vychytil, C. Aufricht and K. Kratochwill (2018). "Effects of Alanyl-Glutamine Treatment on the Peritoneal Dialysis Effluent Proteome Reveal Pathomechanism-Associated Molecular Signatures." Mol Cell Proteomics 17(3): 516-532. dx.doi.org/10.1074/mcp.RA117.000186
• Vychytil, A., R. Herzog, P. Probst, W. Ribitsch, K. Lhotta, V. Machold-Fabrizii, M. Wiesholzer, M. Kaufmann, H. Salmhofer, M. Windpessl, A. R. Rosenkranz, R. Oberbauer, F. Konig, K. Kratochwill and C. Aufricht (2018). "A randomized controlled trial of alanyl-glutamine supplementation in peritoneal dialysis fluid to assess impact on biomarkers of peritoneal health." Kidney Int 94(6): 1227-1237. dx.doi.org/10.1016/j.kint.2018.08.031