Delineating the kidney brain axis in children with severe malaria (KID-BRAIN)

Project summary/ abstract
The overall goal of this career award is to build Dr Batte into an independently funded physician scientist
improving survival of children with acute kidney injury (AKI) and identify interventions that will enable
children to thrive. Dr Batte will delineate mechanisms of kidney-related brain injury in children with severe
malaria. Dr Batte is a Lecturer and a Pediatric nephrologist at Makerere University college of health
sciences. From his past research work, he has established evidence-based approaches to AKI diagnosis
and phenotypic characterization. He has explored the utility of point-of-care tests in evaluating AKI, and has
mechanistically compared severe malaria AKI and non-malaria febrile illnesses related AKI demonstrating
differences in endothelial activation and immune activation. He has also evaluated brain injury and
neurological outcomes of children with AKI following acute malnutrition and sickle cell anemia. He has
published an invited review highlighting challenges in the diagnosis and management of AKI in children and
outlined priorities for future research, which included detailed neuro-developmental assessments following
AKI in children with severe malaria. Dr Batte will use the 75% protected time for the next 5 years working
with his mentors to understand how acute changes in brain-kidney crosstalk translate to long-term injury
and to identify modifiable pathways amenable to intervention to promote adaptive kidney and brain
recovery following severe malaria. Dr Batte has developed an educational plan that builds on his past
training and addresses research training gaps, that once filled will provide the basis to propel him into an
independent research career. This K43 will be structured around specialized training in neurobehavioral
evaluation along with biomarker testing and interpretation. It will help Dr Batte to achieve his objectives
which are to; (1) determine the extent that AKI phenotypes are associated with biosignatures of brain injury
and recovery (2) establish the extent that AKI and AKI phenotypes are associated with cerebral edema (3)
define the association between neurobehavioral outcomes, brain injury biomarkers and AKI phenotypes. Dr
Batte will attain a number of skill-sets in kidney and brain biomarker testing and interpretation, skills in brain
imaging interpretation, data analysis and conduct of longitudinal studies, and neurobehavioral evaluation of
children. It is expected that at completion of this award, with the developed expertise and data generated,
he will elucidate modifiable pathways of kidney-brain cross talk in severe malaria, setting the stage for an
R01 application and a platform for future intervention studies to prevent injury and promote brain and
kidney recovery following severe malaria.

Grant Number: 5K43TW012586-03
NIH Institute/Center: NIH
Principal Investigator: Anthony Batte