SAN ANTONIO, Aug. 2, 2021 /PRNewswire-PRWeb/
-- Researchers at The University of
Texas Health Science Center at San
Antonio, The University of Washington
at Seattle and the Icahn School of Medicine at Mount Sinai in New
York have launched NIRVANA, a National Institutes of
Health-funded pilot clinical study to treat acute kidney injury
(AKI) in COVID-19 patients.
The Health Science Center, also referred to as UT Health San
Antonio, is the coordinating center for the study. The first
San Antonio patients have been
enrolled at University Hospital, said NIRVANA Principal
Investigator and Project Director Kumar
Sharma, MD, professor of medicine, director of the Center
for Renal Precision Medicine and vice chair of research at UT
Health San Antonio.
Vitamin found in diet
The study team is evaluating the effects of a natural treatment
called nicotinamide riboside. A form of vitamin B3, nicotinamide
riboside is present in small amounts in milk. The randomized study
will test the safety of nicotinamide riboside in hospitalized
COVID-19 patients and if a biomarker relevant to acute kidney
injury will be improved with the study treatment.
"The potential benefit for patients enrolled in this study would
be less kidney injury and preservation of kidney function," Dr.
Sharma said. "Our goal is to reduce the severity of acute kidney
disease in patients with COVID-19 and potentially other types of
acute kidney disease."
Acute kidney injury, which is reversible, is sudden loss of
kidney function. It is also called acute renal failure. Patients
with AKI are at higher risk to develop chronic kidney disease,
which requires dialysis treatment to filter waste from the blood
and may necessitate kidney transplant.
How does the treatment work?
Evidence suggests that nicotinamide riboside and other forms of
vitamin B3 can stimulate mitochondrial function in patients with
AKI, Dr. Sharma said. Mitochondria are the powerhouses in cells.
Our bodies need these power plants to generate energy and operate
properly because all organs, especially the brain, heart, and
kidney, require ATP, which is the body's energy currency.
For longer than a decade, Dr. Sharma's research team has studied
mitochondrial dysfunction as a key factor underlying several types
of kidney disease, including diabetic kidney disease and
obesity-related kidney disease.
"The mitochondrial effect is just being recognized as a problem
in COVID-19, and this is one of the first studies, if not the
first, to look at improving mitochondrial function in hospitalized
COVID-19 patients," Dr. Sharma said.
The NIRVANA clinical trial is enrolling 60 patients in
San Antonio, with the sites in
Seattle and New York enrolling another 40, said
Subrata Debnath, PhD,
co-investigator and lead project coordinator from UT Health San
Antonio.
COVID-19 and acute kidney injury
The risk of AKI is greatly increased in COVID-19 patients,
according to dozens of studies conducted in China, Europe
and the U.S.
"When patients develop AKI with COVID, their mortality is much
higher," Dr. Sharma said. The mortality varies in this patient
population and has been reported to be in the range of 35% with
rates as high as 75% to 90% in patients requiring kidney
replacement therapy. (Reference:
https://www.nature.com/articles/s41581-020-00356-5)
NIRVANA is a double-blind, placebo-controlled clinical trial.
Patients hospitalized with COVID-19 and AKI will receive either an
inactive placebo or the study drug nicotinamide riboside orally
twice daily for a total of 10 days.
The Nephrology Division and the Department of Medicine of UT
Health San Antonio are playing a significant role with faculty
members Mir Tariq Ali, MD;
Samin Sharma, MD; and Tareq Nassar, MD, all serving as
co-investigators, along with Nick
Niazi, MD, second-year nephrology fellow. W. Brian Reeves, MD, professor and chairman of the
Department of Medicine, and Thomas
Patterson, MD, professor and chief of infectious diseases,
are co-clinical investigators on the study, as are Saket Kottewar,
MD, MPH, MHA, and Sheena Grant, MD,
from the Division of General and Hospital Medicine. University
Hospital of University Health in San
Antonio is the main participating hospital and is fully
supportive of the inpatient study. The Texas Kidney Foundation
provides community support. Pavan Bhatraju, MD, MSc, at the
University of Washington at Seattle and
Steven Coca, DO, MS, at the Icahn
School of Medicine at Mount Sinai
are site principal investigators at their respective
institutions.
The University of Texas Health
Science Center at San Antonio,
also referred to as UT Health San Antonio, is one of the country's
leading health sciences universities and is designated as a
Hispanic-Serving Institution by the U.S. Department of Education.
With missions of teaching, research, patient care and community
engagement, its schools of medicine, nursing, dentistry, health
professions and graduate biomedical sciences have graduated 39,700
alumni who are leading change, advancing their fields, and renewing
hope for patients and their families throughout South Texas and the world. To learn about the
many ways "We make lives better®," visit
http://www.uthscsa.edu.
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Media Contact
Will Sansom, UT Health San Antonio, 210-567-2579,
sansom@uthscsa.edu
Twitter
SOURCE UT Health San Antonio
