BACKGROUND
The Kidney Dialysis Foundation’s (KDF) existing mission to look after the well being of kidney patients stricken with end stage kidney diseases, the Board of KDF has embarked on its next strategic mission to identify and support research work that lead to the prevention and cure of kidney failure due to diabetes and other complications. To facilitate this, the Memorandum and Articles of Association of the KDF was amended on 7 December 2006 and consent granted from the Commissioner of Charities on 15 March 2007. The Board of Directors on 25 May 2007 restricted fund designated “Research Fund” be set up.

AREAS OF RESEARCH
As 50% of the new dialysis patients are due to diabetic complication of the kidney, a cure of diabetes will reduce the need for dialysis drastically. Through research, KDF aims to move up-stream and support research projects that will lead to the prevention of kidney failure and the need for expensive dialysis treatment. The other possible areas of research would be in area for alternative therapy to replace the existing dialysis treatment

RESEARCH ADVISORY COMMITTEE
To facilitate the review of research projects for their scientific and medical merits, the Board of Directors have commissioned the Research Advisory Committee to be set up under the Chairmanship of Prof Yap Kim Hui, Senior Consultant, Head, Division of Paediatric Nephrolog, Immunology and Urology, National University of Singapore. Other members of the Research Advisory Committee are Associate Professor Lina Choong, Associate Professor Evan Lee and Dr Grace Lee.

WORKING RELATIONSHIP WITH NATIONAL UNIVERSITY OF SINGAPORE
A working relationship is being established with the Yong Loo Lin School of Medicine, National University of Singapore, to provide the resources and infrastructure required to monitor and evaluate the progress of specific projects funded by the KDF Research Fund.  

FIRST RESEARCH PROJECT SPONSORED BY THE KDF-NUS RESEARCH FUND
Many dialysis patients suffer from end stage renal failure due to diabetic complications that affect the kidneys. With a cure for diabetes, the need for dialysis would reduce greatly. It is because of this reason that the cure for diabetes is one of KDF’s main research subjects. Therefore, the very first project to be sponsored by the KDF-NUS Research Fund is a diabetes gene therapy research project, led by leading transplant surgeon Professor Sir Roy Calne, who is a visiting professor at the Department of Surgery, Yong Loo Lin School of Medicine, NUS.

The objective of this research project is to investigate new approaches to the treatment of diabetes using the human insulin gene therapy incorporated into a lentivirus (a genus of slow viruses characterized by a long incubation period and can deliver a significant amount of genetic information into the DNA of the host cell) introduced into the liver. The other aim is to improve on the current procedure of viral delivery to make it less invasive.

As diabetics do not produce enough insulin to lower their blood glucose, stem cells which have the ability to renew themselves through cell division and differentiating into a diverse range of specialized cell types, may be useful in treating diabetics. Some preliminary studies have shown that these cells have a mechanism to prevent immune rejection. The research will study in detail how this anti-immune rejection mechanism works, and how it can be preserved as these cells are induced to secrete insulin.

Once the experiments in the laboratory have shown that these cells are able to secrete insulin when needed, and the researchers have found out how to select the cells that will still escape or prevent immune rejection, these cells will be transplanted into diabetic mice and to see if they really work.

Another aim of the project would be to work on a safe and minimally invasive method to introduce the safe virus, called a vector, carrying the insulin gene directly into the liver of diabetic animals. This will be a procedure that eventually could be applied to diabetic patients.

The 1:1 government matching grant applied by the National University of Singapore has recently been approved and added to the KDF-NUS Research Fund. This would significantly aid us in making an important contribution in this area where the possibility of getting a new form of treatment for these patients is potentially in sight.