Work led by IRR researcher Dr David Baird has found that the protein clusterin found in urine, reflects levels of damaged ‘senescent’ cells in patients with kidney disease. In the future, this urine test has the potential to advance personalised therapy to prevent kidney disease progression in these patients. Kidney disease and senescenceKidney disease affects 1 in 8 people in Scotland and is projected to become the fifth leading cause of premature death worldwide by 2040. A likely contributor to this condition is the build-up of senescent cells - damaged cells that no longer work properly and prevent regeneration. These cells release harmful substances that can worsen kidney damage, especially as people age or after the kidney has been injured.Researchers have discovered that giving medication to remove these senescent cells in mice helps their kidneys heal more effectively. However, bringing this promising treatment to humans has been difficult, partly because doctors currently don’t have a quick, simple way to measure senescence levels in the kidney.Clusterin in urine reflects kidney senescence levels A new study led by Dr David Baird from the Ferenbach lab along with a team of colleagues from The University of Edinburgh and the University of Glasgow may offer a breakthrough. The study used samples from patients with chronic kidney disease in the seNSOR study, which was set up by Dr Laura Denby.The research team found that a protein called clusterin, which can be measured in urine, closely reflects levels of senescence in the kidney. Importantly, in a group of more than 300 patients, those with high levels of clusterin were also significantly more likely to have progression of their kidney disease. Clusterin could be used to identify patients at high risk of chronic kidney disease progression. It could also be used to identify patients with high levels of senescence in their kidney for recruitment to clinical trials of senescent cell–depleting therapies David Baird IRR researcher and paper’s co-first author Urine test applications Researchers are now testing the clusterin-based urine test in a larger group of participants in the NURTuRE CKD biobank. Dr David Baird, now a group leader in IRR, is also exploring its usefulness in other kidney conditions, like acute kidney injury and kidney transplant care.In the future, this urine test could be used to tailor treatments for chronic kidney disease, ensuring that patients most likely to benefit from targeted therapies receive them, while helping doctors track how well these therapies are working.This research brings hope for more personalised care in a disease that affects millions worldwide and is growing in prevalence.This work was supported by funding from the UK Medical Research Council, Kidney Research UK and NHS Lothian Charity. Baird research groupFerenbach research groupLaura Denby's research page and LinkedIn profileNURTuRE BiobankRead the full paper in Kidney International Reports Microscope image showing that the clusterin protein (purple) is expressed in ageing senescent kidney cells (red), but not in healthy non-senescent kidney cells (green). This visual evidence supports the use of clusterin as a marker for identifying senescent kidney cells. Tags CIR Publication date 22 May, 2025
