Name: Mark Hepokoski, MD

Institution: University of California, San Diego

Grant: Ben J. Lipps Research Fellowship Award (2018)

Project Title:  Mitochondrial Dysfunction in ARDS due to AKI
 

How would you sum up your research in one sentence?

• My research seeks to understand how the lungs and kidneys talk to each other during critical illness.

Provide a brief overview of the research you will conduct with help from the grant.

• One way the kidney is unique is that it has more mitochondria than almost every other organ in the body.  Thus, mitochondrial damage and dysfunction is a key feature of acute kidney injury.  It has been discovered recently that damaged mitochondrial fragments, such as mitochondrial DNA, may lead to lung injury when released into the circulation.  With the help from this grant, I will investigate how renal mitochondrial dysfunction leads to lung injury via the release of mitochondrial DNA from damaged kidney cells. 

What impact do you hope your research will have on patients?

• Acute kidney injury (AKI) affects nearly half of all patients admitted to an intensive care unit, and it is a major cause of permanent disability and death.  Interestingly, the leading causes of death due to AKI are distant organ failures, such as respiratory failure.  My hope is that my research will lead to novel therapies that will prevent respiratory failure in patients with AKI, and reduce the unacceptably high mortality associated with this common disease.

What are your short- and long-term career goals?

• My career-goal during the period of this award is to develop the skills necessary to become an independent physician-scientist dedicated to the study of lung-kidney interactions.  I realize that this is an ambitious goal that will likely take at least 5 years, but this award will provide the protected time necessary for the methodologic research training required to be an independent investigator.  In ten years my goal is to be an established physician-scientist with a dynamic lab, and to be a mentor to the next generation of researchers.

What inspired you to focus your research in kidney diseases?

• I am a pulmonary and critical care physician, but as a medical student I always had a passion for renal physiology.  Early in my pulmonary and critical care fellowship, I became frustrated by the high rate of death and lack of therapies for patients with multiple organ failures.  It also struck me that the kidney seemed to be the first organ in a “domino effect” of organ failures that affected so many of my patients.  These patients and their families first inspired me to make kidney injury my main research focus.   My team of mentors at UCSD, Prabhleen Singh, Atul Malhotra, Laura Crotty Alexander, Joachim Ix, and Roger Spragg, continue to inspire me with their enthusiastic support.

What are the major challenges to beginning a career in nephrology research today?

• My greatest challenge is conducting nephrology research as a pulmonary and critical care physician.  However, I have found the nephrology community to be exceptionally welcoming, and I truly believe that breakthroughs in critical care nephrology will require a multidisciplinary approach with pulmonologists, intensivists, and nephrologists. 

Something you may not know about me is…

• I never planned on being a researcher.  My patients and mentors inspired me to give research a try, and I have become completely enthralled by the challenge and potential impact.  I’m so grateful for the opportunity to be a researcher, and I can’t imagine doing anything else. 

In my free time I like to…

• Surf, play guitar, and travel with my wife.  I believe my best research ideas come during these moments.