With a new grant from the National Institute of Allergy and Infectious Diseases, Andrea Conroy's research team will conduct a multi-site study across three hospitals in Uganda over two years to better understand why some malaria patients are more likely to develop chronic kidney disease. The goal is to develop new diagnostic tools and potential clinical trials to support kidney recovery in children. This research represents a significant milestone in the global understanding of pediatric severe malaria and its future treatment.

IU researcher receives grant to investigate acute kidney injury in children with malaria

Jackie Maupin Apr 24, 2023

Clinicians at Mulago Hospital in Kampala, Uganda check on a patient

Clinicians and patient at Mulago Hospital in Kampala, a MAP-CKD study enrollment site.

Andrea Conroy, PhD, assistant professor of pediatrics at the Herman B Wells Center for Pediatric Research at Indiana University School of Medicine, received a significant grant from the National Institute of Allergy and Infectious Diseases to advance research about acute kidney injury in children with severe malaria by launching a multi-site prospective study across three hospitals in Uganda. The grant, “Malaria associated pathogenesis of chronic kidney disease (MAP-CKD)” will enable Conroy’s research group to follow children hospitalized with severe malaria over two years to track survivors' kidney recovery and help understand why those patients are more likely to develop chronic kidney disease.

“Our long-term goal is to develop new diagnostic tools so we can recognize kidney injury earlier in children in low-resource settings and initiate treatment before they progress to more severe disease that is difficult to treat,” said Conroy. “We are also looking at potential clinical trials that can support kidney recovery in children so future patients can have more options available to support their health care needs.” IU and Global Health Uganda scientists at the Pan-African Malaria Conference

IU and Global Health Uganda scientists at the Pan-African Malaria Conference

Conroy’s research practice has been based in Uganda since 2011 where she studies the effects of malaria on children—specifically, acute kidney injury in children with severe malaria. Her group was the first to document acute kidney injury as a common complication in children with severe malaria. There are presently few treatment options available for children developing kidney disease—dialysis is costly and usually inaccessible, and there are no transplant programs in Uganda. Because of these circumstances, most young patients who develop kidney failure do not survive.

Conroy’s kidney research represented a major milestone in the global understanding of pediatric severe malaria and what leads to death in so many children. Malaria is a serious disease transmitted to humans bitten by a particular type of infected mosquito and it’s among the leading cause of global death in children. According to the World Health Organization, there were 247 million cases of malaria in 2021. Because individuals with weak immune systems have the highest risk of contracting malaria, children younger than five accounted for 80% of malaria-related deaths in Africa in 2021.

Conroy’s research also showed that acute kidney injury is a risk factor for long-term brain injury and chronic kidney disease in malaria survivors. These breakthroughs have not only gained notoriety and recognition within the malaria community, but also with the greater nephrology community around the world.

Dr. Anthony Batte at World Kidney Day conference

“Now that we know kidney injury is a major contributor to mortality and affects the neurological and learning outcomes of children with malaria, the MAP-CKD study offers an opportunity to further understand the mechanism of kidney disease in malaria and how we can limit its impact on the brain,” said Dr. Anthony Batte, pediatric nephrologist at Makerere University College of Health Sciences and the study site’s principal investigator. “MAP-CKD is the largest prospective study to evaluate kidney disease in Ugandan children with malaria. Our Ugandan research team will collaborate with Dr. Conroy and other experienced IU researchers to investigate disease mechanisms using novel biomarker testing methods and evaluate beside tests to facilitate kidney diagnosis using easy-to-use tools independent of large-scale infrastructure and electricity.”

Unlike most of her IU colleagues who conduct their research in the Hoosier state, Conroy spends the majority of her time in Kampala, Uganda as the Director of the IU-affiliated CHILD lab, a translational biomedical research laboratory through her efforts with the Ryan White Center for Pediatric Infectious Disease and Global Health Uganda.

Dr. Andrea Conroy at the World Kidney Day conference

Malaria’s global burden is why Conroy has dedicated more than a decade of her life and research in Uganda. During her postdoctoral fellowship, she managed a clinical trial and worked in Jinja for two and a half years while establishing relationships and research partnerships along the way. That experience provided her the opportunity to establish a lab in the country as part of a longstanding partnership between Chandy John, MD, MS, Ryan White Professor of Pediatrics at IU, and Robert Opoka, MD, Executive Director at Global Health Uganda.

“When engaging in global health research, I think researchers have an ethical and moral obligation to ensure research partnerships are authentic, built on trust and ensure there is a significant benefit to the county both in terms of research outputs and also in mentorship and human resource development,” Conroy said. “I am deeply invested in the growth and sustainability of the CHILD lab in Uganda and one of the most fulfilling aspects of my job is being able to mentor students and see them grow as scientists. I think it would be challenging to engage in such mentorship if I wasn't based in Uganda.”

Conroy’s research team is also partnering with Dialysis Without Borders and hopes to expand the partnership within the MAP-CKD project. Patients will begin enrolling in the MAP-CKD study in June 2023.

Author

Jackie Maupin

Jackie supports the Herman B Wells Center for Pediatric Research at IU School of Medicine. As communications generalist, Jackie helps spread the word about the Wells Center's commitment to improving the health of children in Indiana and beyond through basic and translational research. She has several years of experience in non-profit and academic marketing and communications.

The views expressed in this content represent the perspective and opinions of the author and may or may not represent the position of Indiana University School of Medicine.

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