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Dr. Frank Brosius Diabetes & Kidney Disease:  Breaking the Cycle Through Research

Dr. Chip BrosiusDr. Chip Brosius

There is a close interaction among diabetes, kidney disease, and cardiovascular disease. Diabetes is the leading cause of end-stage kidney disease in the U.S., accounting for almost 50 percent of new cases. While diabetes alone is a major risk factor for cardiovascular disease, the development of chronic kidney disease in persons with diabetes further increases the risk by several-fold.

This cycle has repeated itself many times for Dr. Frank "Chip" Brosius during his 19 years of caring for U-M patients. It is a cycle that Dr. Brosius works passionately to break through advances in research focused on curing and stabilizing diabetic kidney disease, and understanding how glucose transport leads to altered kidney and vascular function in diabetic kidney disease and cardiovascular disease, particularly hypertension.

Dr. Brosius, Chief of Nephrology and Professor of Molecular & Integrative Physiology, received his medical degree from the University of Kansas in 1979. Prior to residency, he received fellowship training in Cardiac Pathology at the National Insitute for Health in Bethesda, MD, from 1979-1980. In 1983, he completed residency at the University of Michigan in Internal Medicine. He followed his residency with a four-year fellowship in Nephrology at Beth Israel Hospital in Boston and including post-doctorate research training at the Whitehead Institute in Cambridge. Dr. Brosius joined the UM faculty in 1989 as an Assistant Professor of Internal Medicine and Nephrology.

Along with Dr. Eva Feldman, Dr. Brosius leads the UM site for the NIH’s Animal Models of Diabetes Complication Consortium (AMDCC) project, one of five sister centers of the Michigan Comprehensive Diabetes Center. As director of the AMDCC project at UM, Dr. Brosius works to establish mouse models to better understand the onset and progression of diabetic kidney disease in humans. The AMDCC utilizes the diverse background and expertise of its members to develop animal models that closely mimic human complications of diabetes to study the disease etiology, prevention, and treatment. Additionally, the AMDCC provides resources, protocols and animal models for investigators nationwide.

Dr. Brosius is committed to understanding why kidney damage occurs, especially in diabetes. Preventing diabetic kidney disease would eliminate 50 percent of kidney failure cases in the U.S. “Although we have made progress in slowing diabetic kidney disease, there is still a lot that needs to be done to identify effective treatments to stop the disease,” says Brosius.

Historically, a major focus of Dr. Brosius’ research has been the role of the glucose transporters, especially GLUT1, in the development of diabetic kidney disease. GLUT1 brings glucose (sugar) directly into the cell in the absence of insulin. GLUT1 levels are increased in susceptible cells in the diabetic kidney. Enhanced expression of GLUT1 increases scarring in the filtering units of the kidney and may lead to progressive damage and kidney failure. The research in the Brosius’ laboratory explores the pathways by which changes in GLUT1 lead to kidney disease. The AMDCC is developing new mouse models of diabetic kidney disease that repeat these abnormalities and is studying how glucose transport contributes to the ability of blood vessels to contract and morphologic changes in hypertension.

More recently, in collaboration with three other researchers at the University, Drs. Matthias Kretzler, Sub Pennathur and Eva Feldman, Dr. Brosius is taking a systems biology approach to the research to understand how diabetes complications arise as a result of a complex set of abnormalities and how those abnormalities interact to impact the progression of the disease and the severity of the resulting complications. Rather than looking at only one abnormality, the team studies how individual abnormalities interact with one another to lead to disease. This approach has led to identification of JAK-STAT signaling pathways as a factor in progression of diabetic complications. Higher levels of JAK-STAT signaling pathway proteins are expressed in humans with both diabetic kidney and nerve disease, and the team is now recapitulating such changes in animal models to determine the role of these changes in disease progression.

Dr. Brosius currently serves as chair of the Kidney Council of the American Heart Association. In this role, he advocates for a clearer understanding of the ties between kidney disease, diabetes, and cardiovascular disease. Evidence indicates that as the incidence of kidney disease decreases, the incidence of cardiovascular disease will decrease as well.

He is a long-time member of the American Society of Nephrology and works to promote kidney research and greater awareness of the impact of screening for kidney disease. “It is important to screen earlier because of the long-term and multiple health issues associated with kidney disease,” says Brosius.

Brosius has served as a charter member of an NIH grant review study section as well as on study sections for the American Society of Nephrology, Juvenile Diabetes Research Center, American Heart Association, Department of Veterans Affairs, and others. He serves on the editorial board of the American Journal of Physiology.

Dr. Brosius continues clinical work in nephrology and views all aspects of clinical care as critical.He remains involved in the clinical care of his patients throughout the progression of their battle with chronic disease. Brosius is often “impressed and amazed” by his patients as they deal with and transcend the illness, yet continue to live quality lives. “It’s humbling,” says Brosius. His greatest joy is participating in an organ transplant and seeing his patient cured of kidney disease and diabetes and to be able to lead a normal healthy life.

Dr. Brosius is a recreational runner, and enjoys hiking and backpacking. He is married to artist Kate Roesch and has three daughters.