Exploring Links Between Kidney Disease and Dementia

When Josef Coresh, MD, PhD, MHS (Med ’92, SPH ’92) was named the inaugural George W. Comstock Professor in the Department of Epidemiology, the appointment not only had personal meaning for him – it meant he would be able to invest in innovative research that lacked conventional funding.

“George was like a ‘super mentor’ to me,” says Coresh, “My own mentorship abilities derive from the encouragement George and others provided early in my career.”

Beyond the personal connection, the professorship creates a permanent endowment and allows Coresh to invest seed money in high-risk, high-reward projects that may not be eligible for traditional funding mechanisms.

“With the Comstock professorship, my own goal has been to use the resources to really invest strategically and make the science we do the best it can be,” says Coresh.

In 2002, Coresh worked on the original, universally-accepted definition of chronic kidney disease. Recently, Coresh and his team developed rigorous measures of the progression of kidney disease showing that a 30% decline in kidney function – estimated globally using equations which Coresh helped to develop – predict future outcomes. This measure is already integrated into studies of new drugs to improve outcomes in kidney disease. Coresh also mentors Morgan Grams MD, PhD, MHS (SPH ’10, ’13), a Hopkins nephrologist, and together they showed that the lifetime risk of kidney disease is over 50% and risk of needing dialysis or transplantation is 3% in Caucasians and 8% in African-Americans.

And about 10 percent of the U.S. population – more than 20 million people – have some form of kidney disease. This means that patients and physicians “need to have an awareness of kidney disease that’s similar to what they’ve had with hypertension and diabetes for decades,” Coresh says.

Another recent Coresh team study backed by professorship funds indicates a possible link between the mid-life onset of hypertension and diabetes and later-life dementia, a development that can guide long- term prevention efforts.
Such advances are only fitting for the Comstock Professor. “I think it’s very fitting that Joe Coresh is the first person to have the professorship named for George,” says Emma Lou Comstock, George Comstock’s widow, who adds they have very similar qualities of compassion and commitment.

Comstock, DrPH (SPH ’56), not only taught at the Bloomberg School for more than 50 years, but also pioneered the concept of utilizing biologic samples in long-term epidemiological studies. A world-renowned expert on tuberculosis, he also worked for the U.S. Public Health Service for two decades and founded the Johns Hopkins Training Center for Public Health Research and Prevention in Hagerstown, Md.

Coresh, who also directs the Bloomberg School’s George W. Comstock Center for Public Health Research and Prevention, is a professor in the Department of Epidemiology with joint appointments in Biostatistics and Medicine. He is based in the Welch Center for Prevention, Epidemiology and Clinical Research. He received the 2010 American Heart Association’s Epidemiology and Prevention Mentoring Award, Thompson Reuters – 2014 Highly cited researchers in Clinical Medicine (top 1%), and the 2015 Hume Award from the National Kidney Foundation.