Projects
The Schuh Lab at Cincinnati Children’s aims to reduce the incidence of chronic kidney disease (CKD) in premature, low-birth-weight infants and better understand the long-term impact of CKD. One focus area is minimizing nephron losses and increasing nephron endowment in premature infants. The lab also is investigating the underlying causes of congenital anomalies of the kidney and urinary tract (CAKUT).
Prematurity and Kidney Development Research
Most nephrogenesis occurs prenatally during late gestation (between 34–36 weeks), generating between 200,000 and 2.7 million nephrons per kidney. Individuals at the low end of this range are at higher risk for hypertension, CKD and end-stage kidney disease (ESKD). Prematurity and low birth weight are associated with decreased nephron endowment.
Our lab seeks a molecular understanding of human nephrogenesis during the second and third trimesters, which occurs through a mechanistically unknown process called post-branching nephrogenesis, or lateral branching. Mouse models are inadequate for studying these late stages.
Our lab attempts to uncover these mechanisms using alternative animal models of late gestation human kidney development and confirms our findings with human archival material. We also use single-cell RNA sequencing and multiomic platforms to understand the regulatory transcription changes of gestation in human nephrogenesis. What we discover will lead to a better understanding of normal and abnormal nephrogenesis and potential interventions to improve kidney outcomes for premature infants.
We are also interested in how early exposures and events in the neonatal intensive care unit during ongoing nephrogenesis impact nephron number and susceptibility to injury.
Congenital Anomalies of the Kidney and Urinary Tract Research
Meredith Schuh, MD, a pediatric nephrologist, is part of the multidisciplinary team at the Cincinnati Children’s Fetal Care Center. One of her clinical roles is to counsel families on what to expect after a 20-week prenatal anatomy scan reveals a significant renal anomaly. An extension of this work is her research exploring the genetic causes of such congenital anomalies. Her lab also studies neurocognitive outcomes of babies with CAKUT, as well as neurologic outcomes of infants with CAKUT who had a fetal intervention related to their kidney disease. The Schuh Lab’s discoveries will improve prenatal counseling when a baby is diagnosed with kidney disease during pregnancy and help parents know what to expect long-term.
