Reimagining Kidney Function Assessment Workshop
This workshop aims to help delineate a path forward for a more comprehensive assessment of various kidney functions.
The primary goal of this workshop is to critically assess the existing limitations inherent in our current estimates of kidney function. We have focused on glomerular filtration rate (GFR) and proteinuria as measures of kidney functional status and thus have ignored a wide range of important renal mechanisms that may be affected early or differentially in different disease states. This shortsightedness has limited the tools available to phenotype the full spectrum of kidney disease. The aim of this workshop is to propel a paradigm shift towards a comprehensive approach to assessing kidney function and dysfunction that can improve our ability to describe pathophysiologic mechanisms and disease subgroups. Broadening the approaches and tools we use to measure the functions of the entire nephron will allow us to refine disease classification and enable better targeting of treatments at the right time and for the right individuals.
Analysis and Identified Limitations: Comprehensive Renal Function Assessment
- Inability to Capture Specific Functions of Renal Compartments:
- Challenge: Lack of generally accepted/standardized protocols for capturing the full range of functions of critical renal compartments (e.g., proximal tubule, thick ascending limb, collecting duct, microvasculature).
- Impact: Hinders the ability to measure a comprehensive suite of renal functions; prevents thoughtful endophenotyping of common kidney diseases; prevents recognition of variant forms of kidney disease; prevents recognition of the earliest forms of kidney disease; prevents development of targeted interventions.
- Difficulty in Estimating Average GFR:
- Challenge: Prior measured GFR approaches do not account for the high biological variability in true GFR.
- Impact: Inaccurate estimations hinder our ability to understand the average true GFR and prevent recognition of early disease essential for assessing overall kidney function.
- Lack of a Practical Gold Standard for GFR Measurement:
- Challenge: The absence of a practical gold standard complicates the accurate measurement of GFR.
- Impact: Impedes the development of reliable and universally accepted benchmarks for GFR assessment and the development of robust estimating equations and biomarkers.
- Lack of Established Methods for Assessing Renal Reserve Functions:
- Challenge: Current methods do not adequately assess glomerular renal reserve functions, which is crucial for determining early loss of function.
- Impact: Missed opportunities for early intervention and understanding the progression of kidney diseases.
- Challenges in Assessing Kidney Function and Reserve during Acute Kidney Injury:
- Challenge: Current methods are inadequate for reliably assessing kidney function and reserve during acute kidney injury.
- Impact: Impairs timely and accurate management of acute kidney injury, a critical aspect of overall kidney health.
- Inability to Integrate Various Kidney Function Measures:
- Challenge: Lack of integration of diverse kidney function measures into a specific individual-level global assessment.
- Impact: Hinders the ability to create a holistic understanding of an individual's renal health status, limiting personalized treatment strategies.
Overall Impact: The identified limitations collectively contribute to a significant gap in our ability to comprehensively and dynamically assess various renal functions. This gap impedes the accurate classification of diverse kidney diseases and the development of targeted treatments, hindering progress in the field. To overcome these challenges, it is imperative to establish reliable tools, standardized procedures, and new tailored approaches that address the multifaceted nature of renal function assessment. This workshop aims to address these issues and provide a platform for the formulation of effective solutions that advance the understanding and management of kidney diseases.
February 5, 2024
The link to join the webinar will be distributed via email prior to the date of the event.
Afshin Parsa, M.D., Ph.D.
John Hare, M.S., CMP, CGMP, DES
The Scientific Consulting Group, Inc.