RMIT and Nexsen Develop Blood Tests to Detect Kidney Injury Hours Earlier and Enable At-Home Monitoring

A research team at RMIT University and an Australian diagnostics company, Nexsen Limited, have signed a AUD $1.125 million research contract to build blood tests for kidney disease that work faster than what hospitals use now, and that could one day be used at home.

The need starts in intensive care. Nearly one-third of ICU patients develop acute kidney injury, and the condition is hard to catch in its earliest stages, which is exactly when treatment matters most. Further along the disease spectrum, an estimated 13% of people live with chronic kidney disease, which remains a leading cause of premature death.

The two tests the team is developing are aimed at those two problems. One would identify acute kidney injury hours sooner than current methods. The other would let people with chronic kidney disease monitor themselves at home, which the researchers describe as a first. Professor Vipul Bansal, who directs RMIT's Sir Ian Potter NanoBioSensing Facility, says the approach could be more timely, cheaper and simpler than the pathology-based kidney function tests now in use.

Bansal points to the delay built into today's methods. Diagnosis relies on reduced urine output and rising serum creatinine, which can take six and 24 hours respectively to show up. He says the rapid onset of the injury, paired with the lack of a reliable test, makes timely intervention a major challenge for clinicians. Acting earlier, he explained, can improve outcomes and stop acute injury from progressing into irreversible chronic disease.

Professor Shekhar Kumta explains why the lag exists. A clinician experienced in managing kidney failure in trauma and complex surgical patients, he also heads the Clinical Translational Research Partnership between RMIT and Northern Hospital. Standard tests measure kidney function, such as how well the organs filter creatinine, but creatinine builds up slowly, so a noticeable change can take hours or days. In his words, changes in function trail the damage to the kidney's complex structure. A test that looks directly at damage to different parts of the kidney, he said, would be a real game-changer.

That is what the team is trying to build. They are developing patented DNA aptamers designed to detect specific biomarkers tied to structural kidney damage. Kumta says such blood tests should be able to diagnose the root cause of an injury early, helping define the best management plan for each patient. For chronic disease, similar tests tailored to regular home use could serve more than 850 million patients worldwide, and could sit alongside the blood glucose monitoring many people with diabetes already do daily.

The project builds on an existing relationship. RMIT and Nexsen have signed a memorandum of understanding setting the terms of a long-term strategic partnership, and RMIT recently took an equity position in the company. Several joint appointments tie them together, including Bansal's roles as Nexsen's Chief Innovation Officer and Chair of its Advisory Board.

The platform technology has already been developed for another target: Group B Streptococcus, a bacterium carried by 1 in 5 pregnant women that can cause serious complications for babies. Investigational GBS devices have been manufactured, and a clinical trial at Northern Health in Melbourne has been approved to begin this year, ahead of schedule. Nexsen Executive Chairman Reece O'Connell says both projects aim to deliver rapid, affordable tests for hospitals, clinics and eventually homes, targeting unmet clinical needs in globally significant markets.

The kidney tests are at the research-contract stage. The GBS trial, due to begin at Northern Health, will be the nearest indication of how well the platform performs in patients.