Focus on Research: Understanding Urea Transporters

Jeff Sands, MD

Jeff Sands, MD

Emory Division of Renal Medicine (Nephrology) Director Jeff Sands, MD investigates mechanisms for concentrating urine in the inner medulla of the kidney. Current Emory research projects focus on defining the molecular physiology of urea transporters, since urea transport is a key component in the urine-concentrating mechanism. The ultimate goal of this research is to develop strategies to improve kidney function in patients with nephrogenic diabetes insipidus, a disease that causes frequent urination. These strategies could involve repurposing existing medications to improve patients’ urine-concentrating ability.

Dr. Sands’ research group uses isolated perfused kidney tubules to measure urea transport. They also evaluate the amount, location, phosphorylation status, and subcellular localization of urea transport proteins isolated kidney tubules. Studies are conducted using rat models of abnormal concentrating and diluting ability and genetically engineered mice with knock-out of urea transporter proteins, protein kinase C alpha (PKCα), or the V2-vasopressin receptor.  Using these approaches, Dr. Sands’ lab has shown to show that urea transport and UT-A1 protein are regulated in the inner medulla by both vasopressin-dependent and vasopressin-independent pathways. The vasopressin-dependent pathways include protein kinase A and exchange protein activated by cAMP (EPAC). The vasopressin-independent pathways include protein kinase Cα and AMP-activated protein kinase (AMPK).

Read more about Jeff Sands, MD

Dr. Sands is the Juha P. Kokko Professor of Medicine and Physiology and the director of the Emory University Division of Renal Medicine. Read more

Other research projects led by Jeff Sands, MD

Recently, Dr. Sands has started translating his lab’s basic research findings into clinical practice by investigating whether metformin, a drug that inhibits AMPK and is currently used to treat type 2 diabetes mellitus, is effective in treating nephrogenic diabetes insipidus. Children with this genetic condition can produce almost a liter of urine each hour, and their parents have to make sure they drink at least that much water to stay hydrated. They also hope to test whether metformin alleviates the excessive urination that occurs in adults with bipolar disorder who are treated with chronic lithium.

Currently, he is collaborating with Director of Pediatric Nephrology Larry Greenbaum, MD, PhD and Assistant Professor of Medicine Titi Ilori, MD (Division of Renal Medicine) on initial pilot studies.


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About the Author

Emory Department of Medicine
Emory Department of Medicine
The Emory University Department of Medicine, within the Emory University School of Medicine, is steeped in a rich tradition of excellence. Through the work of its nine divisions and numerous centers and institutes, the department has pioneered discoveries in medicine, education, scientific and clinical investigation, and clinical care. Emory University School of Medicine's medical school, residency, transitional-year, and fellowship programs offer students the latest knowledge in treatment practices, scientific theories, research, and patient care. The Emory University Department of Medicine is a component of the Robert W. Woodruff Health Sciences Center of Emory University, which includes the Emory schools of Medicine, Nursing, and Public Health; Yerkes National Primate Research Center; Winship Cancer Institute; and Emory Healthcare.