Filtering data for better treatments of kidney disease
Research lives: Dr Michelle O’Shaughnessy, clinical assistant professor of Medicine – Nephrology, Stanford University
Dr Michelle O’Shaughnessy: ‘Being able to keep people off dialysis is a major focus.’
What kind of research do you do at Stanford?
I work on kidney disease. I am both a doctor and a scientist. The clinical work and the research inform each other, because you carry out research on the interesting things you see in patients, and then the research will hopefully help us to treat patients more effectively. I am particularly interested in a type of kidney disease called glomerular disease.
What happens in glomerular disease?
Your kidney is full of little filters called glomeruli. In glomerular disease, the immune system attacks these filters and they become leaky. Eventually, the kidney can fail and you need dialysis or a kidney transplant. Glomerular disease affects about 500 of every million people. At the moment, we can’t tell in advance how a person with glomerular disease will do, with or without therapy. So I am looking at ways to figure out what treatments will work best, and are safest, for individual patients.
How are you finding that out?
I analyse existing data, from sources such as health records and insurance claims, to better understand how glomerular disease behaves. I am also part of two major research consortia funded by the National Institutes for Health here in the US. We are building registries, where patients with the disease give blood and urine samples and clinical information, and we look for patterns that predict a patient’s prognosis and their responses to therapies.
What brought you to Stanford?
When I was studying medicine in Galway, going abroad to do specialist training was always on my radar. My colleagues Wael Hussein and Colin Lenihan had moved from Ireland to do a fellowship in nephrology in Stanford, so professionally I [saw] I could build my clinical training and research here. It worked out personally too. My then boyfriend – who is now my husband – works for a technology company headquartered 10 minutes away from Stanford University. So we came over in 2013, and I have been on faculty here since 2016.
What trends are you seeing in kidney disease?
It is increasing. As the population ages and conditions such as diabetes and hypertension – which can damage the kidneys – become more common, we expect to see a big surge in kidney problems. Being able to keep people off dialysis is a major focus.
We also need to find out more about what bothers patients – as clinicians we are interested in urine and blood measurements, but patients want to know things like whether they will need dialysis in the future, or why their legs are swollen or if they will experience side-effects from a drug.
What’s good about your job?
There is a lot of exciting clinical work going on in Stanford – we see interesting and rare cases, treat patients after major surgery and all types of organ transplants, and we have a centre for glomerular disease through which patients take part in several clinical trials. Plus my involvement in multi-centre research groups means I get to work with researchers throughout the US and abroad.
What do you do to take a break?
We love the outdoors, so when we first arrived we explored the area a lot and I did the California thing and got into yoga. We have two small kids now, including a newborn, so our family time is more about play dates and picnics. Getting the work-life balance right is a juggle, but it’s a lovely lifestyle here.