A bold vision: A world without kidney failure

The Transforming Kidney Health Research Panel recently published a report called, "Transforming Kidney Health Research: A Research Agenda for the Future." As the report explains, this roadmap "boldly envisions a future without kidney failure." 

The Transforming Kidney Health Research (TKHR) initiative was launched in 2024. The initiative brought together leaders in the kidney community to assess the current state of kidney disease in the U.S. and consider how it can be changed to address the rising rates of kidney disease and kidney failure in the country. The TKHR panel, which is chaired by American Society of Nephrology (ASN) President-Elect Dr. Samir M. Parikh, includes key kidney stakeholders including physicians, scientists, health care professionals, policy experts, patients, research institutions and nonprofit organizations — including AKF. AKF was honored to have Dr. Charlotte Jones Burton, a member of the AKF Board of Trustees, and Anne Rohall, our director of public policy and a living kidney donor, represent us on this important initiative. 

TKHR's plan focuses on early detection and prevention, transplantation and more cures for kidney diseases to eliminate the need for dialysis as it works now. To accomplish this, the plan calls for a substantial increase in funding for kidney disease research and innovation (approximately $1.8 billion annually over the next 10 years). 

"A century-long underinvestment in kidney research has stalled our search for breakthroughs," Dr. Parikh said in the report's Executive Summary. "Today, the United States spends roughly $17 per patient per year on kidney research — a fraction of the per-patient investments made in cancer. This imbalance has stalled progress, leaving dialysis as the default therapy for kidney failure despite its debilitating impact and poor survival outcomes."

The roadmap lays out a plan for innovation by identifying five connected areas of kidney care which they propose should be prioritized and receive increased federal funding to achieve the overall goal: a world without kidney failure. 

Spotting the Silent Killer

Although there are over 35 million American adults living with kidney disease, about 9 out of 10 of them do not know they have the disease. This is because kidney disease often does not have any noticeable symptoms until it reaches the late stages of kidney failure.

TKHR recommends: "Developing screening tools and platforms using molecules and liquid biopsies, and by harnessing AI and electronic health records" to detect kidney disease earlier when preventative measures can be taken to keep the disease from progressing to failure.

Finding Causes and Creating Cures

Although diabetes remains the leading cause of kidney disease, with other common causes such as high blood pressure, more research is showing that genetic causes are more common than we once thought. Getting an accurate diagnosis helps you get the best treatment for your disease — and helps you know if others in your family are at risk.

TKHR recommends: "Utilizing existing and developing new data sources to identify causes of all the different kidney diseases, including genetics, nutritional factors and interactions with other organ systems, to understand and treat all kidney diseases better."

Transforming Transplantation

If your kidney disease has progressed to life-threatening kidney failure, a kidney transplant is currently considered the best treatment option. However, there are far more people on the transplant waiting list than there are organs available. 

TKHR recommends: "Discarding fewer kidneys by developing innovative strategies for salvaging, rejuvenating and transporting donor kidneys." 

Reimagining Dialysis

For those who cannot receive a kidney transplant, dialysis is a life-saving treatment for kidney failure. However, the treatment has not substantially improved or been updated in many years.

TKHR recommends: "Develop new monitoring and risk prediction tools to tailor dialysis prescriptions better."

Reviving the Research Workforce

The number of research nephrologists has steadily declined over the past 10 years. The American Medical Association reported that the number dropped to just over 300 researchers in 2023, down from 500 in 2016. 

TKHR recommends: "Invest in the development of the kidney research workforce by providing increasing training opportunities in extramural research."

AKF commends ASN and all those who contributed to this important work that provides a clear roadmap to achieve a future without kidney failure.