Dr. Katherine Tuttle, Providence’s executive director for research for the Inland Northwest, has received the 2023 John P. Peters Award—the most prestigious award given out by the American Society of Nephrology.

The ASN lifetime achievement award is given out to just one nephrologist each year and recognizes those who have made substantial research contributions to the discipline of nephrology and have sustained achievements in academic medicine.

“I’m truly humbled that I would even be considered worthy for it,” says Tuttle. “That said, I’ve spent my entire career really focused on just what the (John P.) Peters Award is about—using science to solve problems for patients.”

Nephrology is a branch of medicine that deals with the care and treatment of kidney disease.

Tuttle’s primary research involves diabetes and chronic kidney disease. Diabetes is the leading cause of kidney disease, as it is responsible for about half of the world’s cases, she says.

Arguably Tuttle’s most notable impacts on both nephrology and health care as a whole stem from the experiments she performed with Dr. Ralph DeFronzo, a world-renowned leader in Type 2 diabetes research, which she says laid the foundation for the SGLT2 inhibitor class of drugs.

“Over the past five years, (SGLT2 inhibitors) have become not only breakthrough therapies for kidney disease, but really for human health, because these drugs reduce all-cause mortality by 30%, and risk of kidney failure and heart failure by 25% to 40%.”

SGLT2 inhibitors are a class of prescription medicines used to lower blood sugar in adults with Type 2 diabetes, according to the U.S. Food & Drug Administration. The drugs were developed for treatment of diabetes, and then for treatment of kidney and heart disease, Tuttle says.

Tuttle compares this recent breakthrough of SGLT2 inhibitors being used to treat chronic kidney disease, in terms of number of people affected, to treating pneumonia with antibiotics, or opening up arteries for heart attacks.

“It’s on par with that kind of discovery,” she says.

Kidney disease is a more common and more fatal condition than many people realize, Tuttle says. About 1 in 5 people who walk into Providence’s health care system has kidney disease, and only about 10% of those people are even aware of it, Tuttle contends.

“Nine out of 10 people who have diabetes and develop kidney disease will die on the road to kidney failure,” Tuttle says. “It’s an incredibly fatal disease, which is why a 30% reduction in all-cause mortality … is such a breakthrough. And then among those who live, we see a 40% reduction in kidney failure.”

The main complication of kidney disease that kills people is heart failure, Tuttle says, and with the breakthrough therapies that she and her colleagues helped lay the groundwork for, the heart failure rate is reduced by 25%, she says.

“These are really monumental, paradigm-shifting therapies, and not just in nephrology,” says Tuttle. “This transcends really almost all of medicine.”

Early in her career, Tuttle, who is also an endocrinologist, was performing studies on Type 1 diabetes patients, who endured days-long experiments to get better, but were met with complications, especially kidney disease that mostly went unrecognized and unaddressed until it reached a point of crisis, she says.

“It was as if we had blinders on, and nobody really saw it until people were either dead or crashing into dialysis,” Tuttle says. “It happened to several of the people who were in my Type 1 diabetes studies, and I just thought it was totally unacceptable, and somebody needed to do something, so I decided to sign up. And I’ve been doing it for nearly 40 years.”

Because of her experience, Tuttle decided to pursue a second fellowship in nephrology to try to understand kidney complications with the goal of improving treatments, she says.

Tuttle then went on to explore metabolic parameters to understand how the kidney functions in someone with diabetes. This led to the experiments she conducted with DeFronzo that eventually led to the SGLT2 inhibitors.

On top of her work as a researcher, Tuttle always has maintained a clinical practice, because she feels a commitment to serve people.

“If I have this knowledge and expertise, then I owe it to give back to patients as much as I can directly,” she says. “It also keeps the research focused on the right questions.”

While she is proud of and grateful for the recent breakthroughs in treatment options for patients with kidney disease, Tuttle says there’s a lot more work to do.

“Now the biggest issue is awareness and detection, because nobody benefits from treatments they don’t get,” she says.

When she sees a new patient and tells them they have kidney disease, she says it’s an emotional visit because people fear going on dialysis and fear all the possible complications that can arise.

“Now what we can say to them is we have hope. We have treatments that work,” she says. “But we’ve got to get people in early enough that it matters.”

Part of getting patients these breakthrough therapies, like SGLT2 inhibitors, is that there needs to be payment and health system policies to support the care to pay for the medicine and the monitoring, just like there is for conditions like cancer and heart disease, Tuttle says.

“I hope that we’ll value lives enough to do that,” she says.

Tuttle has also served in numerous faculty roles across multiple academic institutions. She serves as the Institute of Translational Health Sciences regional principal investigator and as a professor of medicine at the University of Washington School of Medicine. She oversees a regional network of 17 clinical research centers and is chair of the UW Research Regional Executive Council.

Tuttle is also a research professor at Washington State University’s Elson S. Floyd College of Medicine.

“We’re very committed to reaching out and hoping that younger or earlier-career people will become interested in kidney disease,” she says.

Tuttle, now 67 years old, has no plans to retire anytime soon, she says.

“I’m still a very active investigator,” she says. “I am not planning to retire. I’m still working on new therapies.”

Tuttle is involved with a group that is about to publish a paper on another new therapy that, when given with SGLT2 inhibitors and other therapies, has shown in a first trial remarkable additional benefits for treating kidney disease, she says.

“We’re aiming for zero, we’re not there yet,” she says.

Along with her colleagues, Tuttle will take the new therapy combination on to an 11,000-person global clinical trial.

“As long as my mind and body hold up, I plan to continue,” she says.

Tuttle earned her medical degree and completed her residency in internal medicine at Northwestern University, in Chicago. She was a fellow in metabolism and endocrinology at Washington University, in St. Louis, and completed her nephrology fellowship training at the University of Texas Health Science Center, in San Antonio.

Tuttle is chair of the ASN Diabetic Kidney Disease Collaborative and has chaired numerous other boards, working groups, and committees for other organizations.

She has been with Providence in various roles for 32 years.