5 Ways to Make Treatment for Chronic Kidney Disease an Approachable Topic for Students

Sana Shujat

The bean-shaped organs on either side of the spine below the rib cage are called kidneys. Kidneys filter the blood to remove wastes and extra fluid from the body. It also balances water, minerals, and salts in our blood. Kidneys release hormones specialized in controlling blood pressure, regulating the production of red blood cells, and keeping us healthy. Damaged kidneys fail to effectively filter the blood, resulting in the body accumulating wastes. 

Anemia refers to the health condition in which red blood cells are deficient. It is often associated with chronic kidney disease (CKD). Symptoms of anemia are less common in early kidney disease but show a dramatic increase with disease progression. According to an estimation, 1 out of 7 kidney patients also suffer from anemia. Such patients are more likely to suffer from heart disease and stroke; therefore, treatment is essential.

Transferring artificially synthesized or recombinant erythropoietin through injections using prokaryotic or eukaryotic vectors is one of the possible treatments against CKD. The synthesis of recombinant erythropoietin and expressing it using bacterial or mammalian cells is a complicated procedure that makes it an overwhelming experience for teachers and students. Keep reading this article to learn five strategies teachers could use in their classrooms to make this topic interesting.


Kidney treatment (Image source)

Why could treatment for chronic kidney disease be a tricky topic?

Advanced topics like treating kidney diseases using biotechnological processes could get overwhelming for some students. Teachers might also need help with the effortless delivery of lectures owing to the complex nature of the topic. 

1. It's complicated 

The scientific apparatus like biosafety cabinet for isolating and synthesizing the desired proteins and spectrophotometer for assessing the protein production makes this topic complicated. Students are bound to be overwhelmed as they impatiently wait for the cultured or incubated cells to show results. There is always a chance of contamination which could be discouraging. Moreover, chemical spills must be handled carefully, unlike spilling a glass of water. If a chemical spill occurs, it is vital to remain calm, warn everybody in the vicinity and analyze the situation. Before initiating any cleanup strategy, you must know what chemical was spilled and what hazards it poses.

2. It’s content-heavy

Students need to learn additional concepts to be able to understand the science behind recombinant technologies in the treatment of diseases. Kidneys produce erythropoietin (EPO) which promotes the production of red blood cells. The genes responsible for the production of EPO are naturally found in the kidneys. However, the liver and extra-renal organs could also produce a small amount of this hormone. 

Recombinant erythropoietin (rhEPO) is administered to chronic disease patients to treat anemia. Students often get dazed with the introduction of the complex process of synthesizing recombinant human erythropoietin in E.coli (prokaryotic) or CHO cells (eukaryotic). The synthesis of biologically active erythropoietin is most practical using the mammalian cell system. The additional information regarding the biochemistry of EPO (disulfide bridges and glycosylation sites) make this topic content-heavy and difficult for many students. 

3. Viewing the histogram from the mass spec machine

The mass spectrometry data of rhEPO expressed in CHO and  E.coli might be challenging to analyze. Continuous practice makes it easy to assess these graphs, but in the beginning, students would need help with it. There are three graphs: 

  • The one on the left shows the total mass of the molecule detected. The graph's peaks correspond to that particular protein's molecular mass.
  • The top right graph shows the overview of the peptide sequence. The peaks in this graph represent one amino acid in the peptide sequence.
  • The bottom right graph shows the magnification of the peptide sequence shown in the top chart.
  • The peaks in this graph represent one amino acid in the peptide sequence. Notice that the diagram of glycan marks the site of glycosylation.

5 ways to make treatment for chronic kidney disease approachable

Treatment for chronic kidney disease can be a manageable topic for students. Here we discuss five practical and efficient strategies that would make this a relatively approachable topic. 

1. Familiarize students with basic and repeated terminologies

Before the lecture, the most repeated terms, like anemia, erythropoietin, recombinant, Escherichia coli, etc., should be discussed. Students may be already familiar with some words, but revision helps them to refresh their memories and follow the teacher better. Any student without understanding these terminologies wouldn’t be able to understand the advanced scientific aspects of this treatment type. 

Chronic kidney disease is a long-term health condition that progressively declines the kidney’s normal functioning. 

Anemia is a blood disorder often associated with diseases like CKD. The red blood cells in anemic patients show a remarkable decline, negatively impacting the blood’s oxygen-carrying capacity. 

Erythropoietin is a hormone/protein synthesized by kidneys responsible for stimulating red blood cells. 

Recombinant erythropoietin (rhEPO) is a drug administered to anemic patients suffering from additional problems like kidney disease. 

Transfection is a process that introduces nucleic acids into eukaryotic cells to modify gene expression to study gene function and products.

A mass spectrometer is an analytical tool used to measure the molecular mass of a sample. The three fundamental parts of a mass spectrometer are the ionization source, the analyzer, and the detector. 

2. Use the methodology of brainstorming

Encourage student participation through class discussion and brainstorming to make the topic accessible. Asking common questions when discussing such advanced issues would trick students into thinking they are familiar with the discussion. It would also help teachers assess the success of learning objectives and outcomes. Some of the questions related to the topic being discussed are as follows. 

  • What is the function of red blood cells?
  • Is E.coli a prokaryote? 
  • Why are mammalian cells a better choice for expressing rhEPO?
  • Is anemia common in all patients suffering from chronic kidney disease?
  • What are good lab practices when handling samples?
  • What is a histogram?

3. Encourage students to draw the processes 

Hands-on learning activities engage both sides (left and right) of the brain. It allows students to process the information better and store the relevant information for a long time. The lengthy process of the bacteria or mammalian expression systems could be made approachable by encouraging students to learn through drawings. Understanding how the prokaryotic expression system differs from the eukaryotic system would be beneficial to comprehending why mammalian cells are a better option. 

The following diagrammatic representation explains the steps required to express rhEPO in E.coli successfully.

bacteria expression system

Bacteria expression system (Image Source)

Diagrammatic representation explains the essential steps required to express rhEPO in CHO cells successfully.

Mammalian Expression System

Mammalian expression system (Image Source)

4. Relate with real-life examples

Giving real-life examples would make it easy for students to relate to the topic. Endogenous EPO was isolated in 1977, and its gene was cloned in 1985 after the humoral control of hematopoiesis was discovered in 1906. Several preliminary clinical trials were conducted to determine its efficacy in treating anemia caused by chronic renal disease (CKD). After demonstrating its ability to eliminate transfusion needs and increase patient well-being, it was approved as a treatment drug for CKD patients in 1988.

Highlight the pros and cons of this treatment strategy. For instance, rhEPO treatment does not guarantee to replace renal transplant outcomes. However, it remarkably improves the life quality in patients. Epoetin, also known as recombinant human erythropoietin (rhEpo), is made from Chinese hamster ovary cells that have been transfected with the human erythropoietin gene. Pure red cell aplasia (PRCA) has occurred due to antibody development against natural erythropoietin or while undergoing recombinant erythropoietin therapy. 

5. Use virtual lab simulation

A virtual laboratory simulation is a great way to teach about chronic kidney disease. At Labster, we're dedicated to delivering fully interactive advanced laboratory simulations that utilize gamification elements like storytelling and scoring systems inside an immersive and engaging 3D universe.

Check out Labster's simulations for Treatment for Chronic Kidney Disease Virtual Lab. In this simulation, you’ll get to prepare the rhEPO that is transfected virtually into bacterial and CHO cells. The learning process is sped up as the incubation time only takes a few seconds. It helps students to learn valuable knowledge of the synthesis of rhEPO quickly and efficiently. The mass spectrometry histogram shown in the snippet below is equipped with a quiz encouraging students to assess what they’ve learned. 

Please take a look at the following snippets taken from the Labster simulations or get in touch to find out how you can start using virtual labs with your students.

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