4.7 Editorial Material

Rationale and design of the Kidney Precision Medicine Project

Journal

KIDNEY INTERNATIONAL
Volume 99, Issue 3, Pages 498-510

Publisher

ELSEVIER SCIENCE INC
DOI: 10.1016/j.kint.2020.08.039

Keywords

acute kidney injury; chronic kidney disease; diabetes; hypertension; precision medicine

Funding

  1. NIDDK [U2C DK114886, UH3DK114861, UH3DK114866, UH3DK114870, UH3DK114908, UH3DK114915, UH3DK114926, UH3DK114907, UH3DK114920, UH3DK114923, UH3DK114933, UH3DK114937]

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The Kidney Precision Medicine Project aims to characterize kidney diseases at a molecular level, identify disease subgroups, and discover novel therapies. This multicenter study involves obtaining kidney biopsies, creating a kidney tissue atlas, and conducting in-depth analysis to improve understanding of chronic and acute kidney diseases. Participants will be followed for 10 years to track clinical outcomes, and all data will be made available for broad use by researchers, clinicians, and patients.
Chronic kidney disease (CKD) and acute kidney injury (AKI) are common, heterogeneous, and morbid diseases. Mechanistic characterization of CKD and AKI in patients may facilitate a precision-medicine approach to prevention, diagnosis, and treatment. The Kidney Precision Medicine Project aims to ethically and safely obtain kidney biopsies from participants with CKD or AKI, create a reference kidney atlas, and characterize disease subgroups to stratify patients based on molecular features of disease, clinical characteristics, and associated outcomes. An additional aim is to identify critical cells, pathways, and targets for novel therapies and preventive strategies. This project is a multicenter prospective cohort study of adults with CKD or AKI who undergo a protocol kidney biopsy for research purposes. This investigation focuses on kidney diseases that are most prevalent and therefore substantially burden the public health, including CKD attributed to diabetes or hypertension and AKI attributed to ischemic and toxic injuries. Reference kidney tissues (for example, living-donor kidney biopsies) will also be evaluated. Traditional and digital pathology will be combined with transcriptomic, proteomic, and metabolomic analysis of the kidney tissue as well as deep clinical phenotyping for supervised and unsupervised subgroup analysis and systems biology analysis. Participants will be followed prospectively for 10 years to ascertain clinical outcomes. Cell types, locations, and functions will be characterized in health and disease in an open, searchable, online kidney tissue atlas. All data from the Kidney Precision Medicine Project will be made readily available for broad use by scientists, clinicians, and patients.

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