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Advancing Kidney Disease Guidelines: Power of International Multidisciplinary Collaboration

Coordinating this global consortium has been the best part of my career – we get to work with great people on global data to answer important, challenging questions while developing or adapting innovative methodology.

Josef Coresh, MD, PhD, Principle Investigator of the Chronic Kidney Disease Prognosis Consortium (CKD-PC)

Clinical practice guidelines rely on high-quality evidence from clinical and epidemiological research. The Chronic Kidney Disease Prognosis Consortium aims to improve clinical practice and research, mainly for kidney disease, by conducting sophisticated meta-analyses. The consortium is growing every year with over 70 cohorts including more than 11 million individuals from 40 countries in 2016.

The CKD-PC was established in October 2009 at a controversial conference in London (supported by the Kidney Disease: Improving Global Outcomes and the US National Kidney Foundation to proactively provide new objective evidence for updating guidelines of CKD definition and staging. Welch Center faculty played pivotal roles in compiling data from ~50 cohorts with ~1 million study participants and providing standardized meta-analysis data for the conference, leading to the formation of CKD-PC. The resulting work from that conference became the backbone of the new guidelines on the definition and staging of CKD, with an emphasis on characterizing CKD with two axes of reduced kidney function and albuminuria.

The success of the CKD-PC has allowed it to grow in size and extend research topics. As of 2016, the consortium includes over 70 cohorts including more than 11 million study participants. CKD-PC also has informed clinical guidelines and regulatory agencies in several other aspects, such as how to best estimate kidney function, whether changes in kidney function can be an optimal donor for kidney transplantation, and how to evaluate optimal donor for kidney transplantation. Such productivity and impact are based on multidisciplinary collaborations among a wide range of specialties, including nephrologists, internists, endocrinologists, cardiologists, epidemiologists, and biostatisticians, which mirror the diverse and collaborative atmosphere of the Welch Center.

The Data Coordinating Center for this global consortium was set up at the Welch Center. Several Welch Center Faculty and Staff are core members of this small but multidisciplinary group, including Drs. Josef Coresh (PI), Kunihiro Matsushita (Director), Morgan Grams (Director of Nephrology Initiatives), Shoshana Ballew (Assistant Project Director), Mark Woodward (Senior Statistician), and Ms. Yingying Sang (Lead Biostatistician). 

Dr. Coresh and the CKD-PC leadership agree on the importance of fostering opportunities for dedicated junior faculty researchers and exceptional post-doctoral fellows to take on important roles in consortium activities, including participating as members of collaborative cohorts from around the globe. 

As an accelerated topic for the phase of 2016-2017, the consortium will be working with KDIGO on a controversies conference regarding the prognosis and management of advanced stages of CKD. CKD-PC is also hoping to evaluate the implementation of its findings to clinical practice.  Thus CKD-PC continues work to improve clinical guidelines, patient care, and healthcare policy by catalyzing the best available data, state-of-the-art analytic approaches, and constructive collaborations at multi-levels.