ASN's Mission

ASN leads the fight to prevent, treat, and cure kidney diseases throughout the world by educating health professionals and scientists, advancing research and innovation, communicating new knowledge, and advocating for the highest quality care for patients.

learn more

Contact ASN

1401 H St, NW, Ste 900, Washington, DC 20005

email@asn-online.org

202-640-4660

The Latest on Twitter

Kidney Week

Abstract: SA-PO393

Conceptualizing the Future of Personalized Precision Medicine for Glomerular Disease

Session Information

Category: Glomerular Diseases

  • 1203 Glomerular Diseases: Clinical, Outcomes, and Trials

Authors

  • Gipson, Debbie S., University of Michigan Mott Children's Hospital, Ann Arbor, Michigan, United States
  • Trachtman, Howard, NYU Langone Health, New York, New York, United States
  • Barisoni, L., U. Miami, Miller School of Medicine, Miami Beach, Florida, United States
  • Hodgin, Jeffrey B., The University of Michigan, Ann Arbor, Michigan, United States
  • Hamidi, Habib, University of Michigan, Ann Arbor, Michigan, United States
  • Eddy, Sean, University of Michigan, Ann Arbor, Michigan, United States
  • Mariani, Laura H., University of Michigan, Ann Arbor, Michigan, United States
  • Sampson, Matt G., University of Michigan, Ann Arbor, Michigan, United States
  • Holzman, Lawrence B., University of Pennsylvania, Philadelphia, Pennsylvania, United States
  • Troost, Jonathan P., University of Michigan, Ann Arbor, Michigan, United States
  • Sedor, John R., Cleveland Clinic, Cleveland, Ohio, United States
  • Kretzler, Matthias, U.Michigan, Ann Arbor, Michigan, United States

Group or Team Name

  • Nephrotic Syndrome Study Network
Background

Glomerular disease therapy selection and outcomes have been hampered by imprecise disease characterization. Scientific advances have been generated in research contexts but few have crossed the research - patient care divide.

Methods

We hypothesized that comprehensive clinical, demographic and molecular phenotypes could be integrated into a personalized, comprehensive disease profile that could be used to understand the disease within nephrotic syndrome subjects. Physician- scientists and project managers from NEPTUNE were invited to participate in the model development. A multicenter, interdisciplinary NEPTUNE Kidney Review Board (KRB) model was created. Testing of this model used archived cases from the NEPTUNE study cohort. Return of results to caregivers or subjects was prohibited during this model testing phase.

Results

Data domains including, clinical phenotype, pathology, genetics, renal gene expression, and proteomics, were evaluated for each case. KRB participants were educated about data domain content, analytic methods, results display and supporting evidence from published literature. Multicenter web-enabled conferences were used to a) present case-specific information, b) review subject-specific data for each domain and c) integrate the multi-scalar data to develop theoretical management and treatment strategies for the subject. The multicenter, NEPTUNE KRB pilot was launched in February 2018. This pilot phase allowed the team to practice baseline evaluation of each case using a systems biology approach in a blinded manner, assemble the information into a case specific knowledge environment. Following discussion, the outcome of the case based on longitudinal observation was disclosed.

Conclusion

Integration of clinical, pathologic and molecular data will enable personalized disease profiling and will be essential in matching the right therapies for the right patients. In order to accomplish this, a prepared community of clinicians and scientists are needed to effectively interpret the strengths and limitations of the evidence. Furthermore, addition of patient advisors and ethicists will strengthen this initiative. KRBs provide a rational and effective strategy to bring precision health to the glomerular disease community.

Funding

  • NIDDK Support