Researchers identify marker that predicts cell death in kidneys

When the kidneys are damaged – after surgery, cardiac arrest, or as a side effect of certain medications – doctors often face one crucial question: Will the kidneys recover, or is the damage permanent?

A research team from Aarhus University may now have found an answer. A protein known as VCAM1 appears to be a reliable marker for whether a kidney cell will survive or die.

“We found that around 80 percent of the damaged kidney tubules died if they expressed VCAM1. The protein appears a few days after injury and marks exactly those cells that will not recover,” says Associate Professor Ina Maria Schiessl from the Department of Biomedicine, who led the study.

Scar tissue is not the problem

The study also challenges a long-standing assumption about kidney disease.

For many years, doctors believed that scar tissue spreads and destroys healthy areas of the kidney. But that’s not the case, the researchers found.

“The scar tissue stays confined to the injured areas. In fact, it seems to protect the healthy cells by forming a kind of barrier,” explains Schiessl.

This could help explain why drugs targeting scar tissue have repeatedly failed in clinical trials.

Findings translate to humans

The researchers also examined tissue from 26 Danish kidney transplantations. Patients with high VCAM1 levels six days after surgery had significantly poorer kidney function one year later.

“This suggests that we may be able to predict which patients are at risk of developing chronic kidney disease – long before it shows up in blood tests,” says Ina Maria Schiessl.

The discovery indicates that doctors have only a narrow window to act before the damage becomes irreversible.

“If we can prevent cells from dying – or remove the dead ones quickly – we could potentially save many more patients,” she adds.

Acute kidney injury affects between one in five and one in two hospitalized patients worldwide. Many seem to recover but still face up to eight times higher risk of developing chronic kidney disease later in life.

“There are potentially millions of people who could benefit from a more targeted treatment. We’re still a long way from clinical trials – but there is a clear path,” says Ina Maria Schiessl.

Behind the research

Study type: Translational research study combining animal experiments (transgenic mice) with serial intravital microscopy over 3 weeks, plus analysis of human kidney transplant biopsies, plasma, and urine samples from the CONTEXT trial.

Collaborators: Aarhus University and four European transplant centres. 

External funding:

Potential conflicts of interest: No conflicts of interest declared.

Link to scientific article: Science Advances, October 22, 2025 DOI: 10.1126/sciadv.adz5358