Jan Hurlbut: Enabling faculty to change the playing field and "think big"

Jan Hurlbut and James Brooks, MD

Jan Hurlbut is a retired schoolteacher from Palos Verdes, California, looking to create major change on the playing field for people with chronic kidney disorders.

Because of her own challenging experience, she wants to be a force to help prevent the suffering inflicted by these destructive medical conditions. She is bent on supporting research to find causes and develop treatments.

In her case, a congenital kidney problem went undiagnosed for years. “It was many years before it was correctly diagnosed. And it took many doctors—about eight.

“There are a lot of horrible problems, irritating problems, that have been ignored. And that distresses me,” she says. “We need more research.”

“One evening, at a dinner for the Hoover Institution, I was seated at the same table as Dr. Scott Atlas. Which was very fortunate,” she says. Dr. Atlas is the David and Joan Traitel Senior Fellow and an expert on health care policy.

“I said to him, ‘Do you know anybody in urology who would be interested in doing research on hydronephrosis?’”

Hydronephrosis results when, because of a blockage or obstruction, urine cannot drain from the kidney to the bladder. Kidneys can become diseased or lose function permanently. Severe blockage  can  even lead  to  sepsis, a dangerous infection in the bloodstream.
Jan is especially interested in supporting research to detect  and  predict the  condition very early  in  the  game. Dr. Atlas introduced Jan and her late husband, Keith, to James Brooks, MD. Dr. Brooks, a urologic surgeon at Stanford Medicine, develops diagnostic and prognostic markers for urological diseases, including prostate and kidney cancer.

“[Jan Hurlbut's] support is making it possible for me to press toward this goal,” says Dr. Brooks. “No one in my field is really looking at the early steps that lead to damage. Most scientists are focused down the road, on therapies that can be used after the damage is done.”

“Dr. Brooks was a miracle,” she says. When she comes to Stanford to visit the campus, she often sees him. They will have dinner together, and a lively discussion ensues.

Invariably, she will ask him, “Have you solved it yet?”

“Hydronephrosis was an entirely new and thrilling area of investigation for me when Jan found me,” says Dr. Brooks. “I’ve thanked her many times for opening my eyes to this uniquely interesting area that has received very little attention or funding.” He is one of the few researchers in this field, which affects at least two to three percent of adults and two percent of infants.

“The challenge we face as physicians is to determine whether and when we should perform surgery to repair obstructions. Because the symptoms don’t always match the threat to the kidneys, we currently have to base our decision on imaging or blood tests. These are imprecise or much delayed measures of kidney damage,” says Dr. Brooks. “Surgery often occurs only after the kidneys have been damaged.”

Jan and Dr. Brooks together share a quest for creating a way to detect the problem so that doctors can intervene before permanent kidney damage occurs.

“Her support is making it possible for me to press toward this goal,” says Dr. Brooks. “No one in my field is really looking at the early steps that lead to damage. Most scientists are focused down the road, on therapies that can be used after the damage is done.”

Jan wants to encourage people to contribute to medical research in whatever area they are interested in, in whatever amount they are comfortable with.

“Too many people have problems that should be diagnosed correctly. We need more money going into research. It doesn’t have to be huge amounts.

Find an area to support and stick by someone who can help research that, to investigate and discover the cause of a disease,” she says.

“It just requires interest and perseverance.”

Following her husband Keith’s death, Jan endowed the Keith and Jan Hurlbut Professorship, intended for an eminent faculty member in the field of urologic disorders.

Dr. Brooks is the inaugural holder of the chair; the endowment frees up time and money to pursue research that otherwise would not be happening. Because of this support, Dr. Brooks is making great strides in identifying biomarkers that reflect damage from kidney blockage.

Biomarkers are indicators of the body’s response to a medical condition or the threat of one, such as a fever pointing to infection or inflammation.

“My goal is to discover a non-invasive, urine-test biomarker to help protect people’s kidneys,” he says. Dr. Brooks looks for biomarkers that take the form of a gene either being turned up (up-regulated) or turned down (down-regulated).

Dr. Brooks has narrowed down a list of promising candidate biomarkers that predict kidney damage arising from obstruction. He is now conducting international, collaborative clinical trials and is in the next phase of building    a standard molecular biology test that can be run in a clinic.

“Ultimately, we want to intervene to prevent the damage by giving patients a therapeutic that turns off the pathway.” As his work forges ahead, Dr. Brooks keeps in touch with Jan by sharing regular updates.

“Her gift will make a critical impact on the lives of many people by enabling them to avoid the devastating effects of hydronephrosis,” he says.

“All of this is based on unique collaborations that couldn’t have happened anywhere other than Stanford, and couldn’t have happened without Jan’s generous support. Based on our successes I am encouraged to think big.”