Final NephCure Kidney Network Data Snapshot August 2, 2018 by Kylie Karley Since 2014, NephCure Kidney International (informally called NephCure) enthusiastically collected your survey responses in a systematic and safe way to help researchers and doctors better understand Nephrotic Syndrome, FSGS, and related diseases. Over the past few years, we have released annual reports about the trends of diagnosis patterns, treatment options, and your opinions about research and clinical trials. In addition, through our participation in larger networks of data (thanks to our involvement in PCORnet), we learned about electronic health record access for Nephrotic Syndrome patients, sleep habits, and potential mobile app use. We are pleased to release the final Annual Report, which includes data collected over a 13-month period between 2017 and 2018. While the NephCure Kidney Network Patient Registry is no longer open to registrants, the data will be available for researchers to study for the next 3 years (should they be approved by a patient-centric committee for data access). If you have any questions about the NKN Patient Registry, please email registry@nephcure.org.
NephCure Funded Research: Dr. Michelle Denburg October 3, 2017 by Lauren Eva Dr. Denburg is focused on improving outcomes for pediatric Nephrotic Syndrome patients. In 2012, NephCure and the ASN Foundation awarded Dr. Michelle Denburg, a pediatric nephrologist at the Children’s Hospital of Philadelphia, a research grant to study vitamin D deficiency in the Nephrotic patient. Dr. Denburg is also a Co-Principal Investigator of the NephCure Kidney Network, a patient-reported outcomes registry for individuals with primary Nephrotic Syndrome diseases. We were thrilled to speak with her recently to learn more about her work and the impact that the NephCure-ASN grant has had on her research. Dr. Michelle Denburg NKI: In 2012 you received the NephCure-ASN award for your research on vitamin D deficiency in the nephrotic patient. Can you tell us a little bit about your work that NephCure has helped fund? Dr. Michelle Denburg: There are two studies that were related. One was an ancillary study to NEPTUNE, where we analyzed NEPTUNE baseline samples, measuring vitamin D metabolites and their hormonal regulators. We were looking at the relationships between what we already know in terms of Chronic Kidney Disease (CKD) and vitamin D, but specifically in terms of proteinuric glomerular diseases: the impact of proteinuria and relating some of the abnormalities of vitamin D metabolism to biopsy data and gene expression from the biopsies. The other study is a trial of vitamin D supplementation in patients with Focal Segmental Glomerulosclerosis (FSGS) and other glomerular diseases with persistent proteinuria—basically, treatment resistant patients. [editor’s note: The Nephrotic Syndrome Study Network, or NEPTUNE, is a long-term observational study that was formed to help understand the biology behind Nephrotic Syndrome. NEPTUNE has gathered health data and biological samples from close to 2,000 glomerular disease patients nationwide. Researchers can apply for grants, called “ancillary studies,” to conduct research on this de-identified patient data. Besides having helped fund the creation of NEPTUNE, NephCure also now helps provide the funding that make a number of the ancillary studies possible.] NKI: I know this work has not yet been published, but is there anything from those studies that you can share with us at this time? Dr. Denburg: There are some important things that we are going to be able to demonstrate and report. It’s fairly novel that we have measured vitamin D levels in the blood as well as the expression of vitamin D related genes in the kidney of people with glomerular disease. A lot of what we know about vitamin D metabolism comes from animal models. The fact that we have the NEPTUNE patients’ biopsy data and can relate the gene expression of these enzymes that are involved in vitamin D metabolism to their serum levels—this is highly novel from the research side. From the patient and clinician side, this is the largest study of vitamin D related mineral metabolism in a glomerular cohort. The prior literature is small case studies—this study included several hundred people. NKI: Do you think this work will change how patients are treated in their doctors’ offices? Dr. Denburg: I can’t comment too much on the results of these studies which have not been published yet, but the findings could have important clinical implications. I think the nephrology community may need to consider updating our guidelines on vitamin D replacement in nephrotic patients. Our current guidelines are based on CKD in general. In other words, there is no guideline for patients with glomerular diseases who may have normal kidney function but a lot of proteinuria, or patients who have glomerular disease and CKD. And we know that patients with glomerular disease in particular have several obstacles to bone health. One of my motivations behind this project is my interest in what we can modify to improve bone health in children and adolescents. Many of our patients are being exposed to a lot of steroids over time, and this is over the same period of time that they’re accruing the vast majority of their skeletal mass: about 90% of the skeleton is laid down before age 18. I’m interested in learning what we can do to modify and improve bone health in the face of therapies and illnesses we can’t avoid—that is, until we find a cure. NKI: How do we separate the way steroid use affects bone health for glomerular disease patients to how having CKD in general affects bone health? Dr. Denburg: I don’t know that glomerular patients need to be considered separately so much as have their unique risk within the CKD population considered. By definition, even someone with normal renal function who has glomerular disease is at CKD stage 1. At a certain point, everybody starts losing bone. What kids come away with in terms of their skeleton by the time they enter the adult world is a huge determinant of their later fracture risk and other skeletal burden over time. You can never get that opportunity to address bone health back. You do accrue some cortical mass until age 30, but the majority of what you have is what you can accrue in your skeleton by age 18. Children and teenagers with glomerular disease have unique risk factors: high dose and long term steroid therapy, abnormalities in vitamin D metabolism, ongoing, persistent, heavy protein losses, and inflammation. There are a variety of risk factors that we can hopefully address. NKI: The computable phenotype is another project I know you’re working on, and it sounds like it could be a game-changer. What is your role in that project and what about it excites you for the future of glomerular disease? Dr. Denburg: That’s a very exciting avenue of research. Much of my effort on that is supported by the NephCure Kidney Network. The computable phenotype is a way of identifying patients with glomerular disease through electronic health records (EHRs). It’s being developed in collaboration with PEDSnet [a large clinical data research network, composed of eight health institutions], so it represents over 5 million children and adolescents. The idea is that by running a computer programming code with essentially the push of a button, you can very rapidly say, here are the approximately 3,000 kids who have glomerular diseases across PEDSnet. And this is not static data, this is real life clinical care data. You could run the programmatic code again three months later and identify new cases. This is opposed to the traditional method where someone is sitting and going through the charts at each institution, which is not very time or cost effective. The idea is that this is a means of rapid cohort identification. You can do observational studies on this population’s de-identified data. Or, with regulatory approval, you can contact patients and invite them to be in observational studies and clinical trials. You can also do trials in a more pragmatic way: you can invite patients to participate in a study where they don’t necessarily have to be followed by a typical regimented protocol with extra clinical visits, which is very laborious and cost-intensive. Instead, using this method, if we wanted to do a larger vitamin D study, we could consent individuals for a study and say, we’re going to randomize you to a group that either gets a lot of vitamin D or a group that gets a little vitamin D, abut then after that all your care is going to be your routine care with your clinician. Instead of having you come to separate appointments to track the effects of the vitamin D levels, we’re going to capture your data in regards to this study through your EHR. And we’ll leave it up to your own nephrologist to follow your levels and change your dosage. That’s what I mean by a pragmatic trial. I should say, the study has to lend itself to that—a high risk, new drug study is never going to be implemented in this manner. NKI: And that more closely mimics real life; how a treatment would be used in real life vs. in a highly-regimented protocol. Dr. Denburg: Right—so you lose a little of the very protocolized follow up, but you gain the real-life applicability and generalizability. NKI: What impact did receiving the NephCure-ASN award have on your research? Dr. Denburg: It was really mission-critical. I was a junior person, two years out of fellowship at that point, and it enabled me to build a research program. It helped me in getting my Career Development (K) Award from the National Institutes of Health, and the combination of those two awards allowed me to develop my research program and to have the ability to pursue multiple directions. I like that I get to do patient-oriented research where I’m directly enrolling patients in studies of vitamin D treatment or assessing bone quality through imaging, but then I can also do studies where I’m accessing robust samples from NEPTUNE and entering this large data world. There are things you can do in each that really complement the other. And it’s the way to push things forward, moving between the analysis of large sources of data and then taking it back to the patient and vice versa. So I’m very grateful for the funding. I feel lucky. As pediatric nephrologists, Nephrotic Syndrome makes up a significant portion of patients we see and treat. Being a clinician who sees these patients really helps in keeping you attuned with what needs to be addressed from the research side—the patient care really drives the research questions. We were delighted to learn more about Dr. Denburg’s research. Check back at www.NephCure.org to stay updated on her soon-to-be published work and other advances in the field. Thank you for your passion and commitment to improving the health of patients with Nephrotic Syndrome, Dr. Denburg! Dr. Michelle Denburg, MD, MSCE, is an Assistant Professor of Pediatrics at the Perelman School of Medicine of the University of Pennsylvania and the Children’s Hospital of Philadelphia. Dr. Denburg’s research focuses on bone and mineral metabolism in childhood kidney diseases, including chronic kidney disease (CKD), glomerular disease, and urinary stone disease. In particular, she has pursued translational work in vitamin D-mediated innate immunity in nephrotic patients and ancillary studies of vitamin D metabolism and vitamin D-binding protein in pediatric patients with CKD. Her collaborative studies have focused on vitamin D metabolism and bone structure in children with CKD, nephrotic syndrome, and inflammatory bowel disease. Dr. Denburg’s study of incident fracture risk in the Chronic Kidney Disease in Children (CKiD) cohort was the first to evaluate the burden of fractures in a large pediatric CKD cohort. She is a co-principal investigator in a project of the CKD Biomarkers Consortium that seeks to identify novel biomarkers for CKD progression in children. She has conducted several population-based studies of fracture risk in chronic diseases and CKD epidemiology using The Health Improvement Network (THIN) Database. She also has led the development of and serves as co-principal investigator of a Pediatric Glomerular Disease Learning Health System (LHS) within the PEDSnet clinical data research network. Dr. Denburg attended medical school at the Weill Medical College of Cornell University and received her Master of Science in Clinical Epidemiology from the University of Pennsylvania.
Watch the Demystifying Research Webinar! July 21, 2015 by Kylie Karley Watch NKI and special guest speaker Dr. Jonathan Hogan from The University of Pennsylvania, as we demystify Nephrotic Syndrome research! Research is important to all members of the NS community- so why not learn about it! We talk about how research works, what is happening in the NS research world, and what patients and their families can do to help. Come with your research questions, and prepare to have them answered! CLICK HERE TO WATCH THE WEBINAR
Test The New ‘My Kidney Buddy’ Mobile App! June 15, 2015 by Kylie Karley Are you buried in paper from all your doctor visits? Ditch the binder- there’s an app for that! As part of the NephCure Kidney Network Patient Registry (www.nephcurekidneynetwork.org) we are developing a mobile app that makes keeping track of your paper medical records a thing of the past! My Kidney Buddy conveniently tracks crucial information such as new symptoms, current medications, and lab values and allows you to easily access them on your smartphone. Additional features include a graphing function so you can better track changes in your lab values over time. The My Kidney Buddy diary feature also allows you to track changes in your diet or if new symptoms occur. Coordinating your care can be complicated and it is important that you and your physician have all your important medical information available. By using My Kidney Buddy, you can be sure that your important health information is recorded and can be easily relayed to your physician… all without the hassle of carrying a heavy binder! We are looking for ‘beta testers’ to try this application and give us feedback on your experience prior to its release to the general public- and we need your help! Help us help you by testing My Kidney Buddy today! Email Chelsey Fix at cfix@nephcure.org for more information.
NephCure Kidney Network Annual Report Release May 8, 2015 by Kylie Karley We are pleased to provide you with a copy of the first Annual Data Report of the NephCure Kidney Network Patient Registry. The 2015 Annual Data Report summarizes the data provided by 350+ Registry participants collected from March 2014 to March 2015. Click here for the full report Please contact registry@nephcure.org with any questions.
NKN Steering Committee: Now Accepting Applications April 17, 2015 by Kylie Karley The most unique aspect of the NephCureKidney Network Patient Registry is that it is governed by a group of patients, patient parents, patient advocates, clinicians, researchers and representatives from industry who work together to ensure that the needs of the NS patient community and the NS research community are met. Each month this group of 18 individuals meets via conference call to discuss topics focusing on recruitment and retention, patient engagement, data collection, and medical profession engagement. Because each group of stakeholders can voice their perspectives on the call, it is ensured that the NKN registry will remain both patient centered and a valuable tool for the research community. Want to be involved? If you are interested, email Joanna Dauber at jdauber@nephcure.orgor call 610-540-0186 x 36. Applications will be accepted until April 27th, 2015.
2014 Research In Review February 20, 2015 by Kylie Karley What a Year We Had in 2014! Thank you to all those who collaborate with NephCure Kidney International (NKI) to advance its mission to support research leading to better treatments and cures for those suffering with FSGS and other Nephrotic Syndrome diseases. 2014 saw several major successes in the research world that move us closer to achieving our goals. Below is a summary of NKI’s 2014 research-related accomplishments. NEPHCURE KIDNEY NETWORK PATIENT REGISTRY Hundreds of people with primary FSGS and related glomerular diseases enrolled in the newly launched NephCure Kidney Network Patient Registry. These patients and care givers of patients are at the forefront of a movement called “patient powered research”. By sharing and comparing data contributed by patients about their health and quality of life, we can accelerate the development of new treatments, including new drugs. It is important for people with a rare disease to STAND UP & BE COUNTED to ensure research focuses on the issues of greatest importance to patients and their families. To learn more or enroll, click HERE. RESEARCH GRANTS In 2014, the NKI grant program committed over $2.6 MM in support for scientific investigations that advance knowledge about the cause of NS disease, evaluate possible drug targets and help physician/scientists track the natural history of these rare diseases. Click HERE for more information about grants awarded to investigators at Washington University Medical Center, Boston Children’s Hospital and Rush University. For more information about the research consortia we support, click HERE for the Nephrotic Syndrome Study Network and HERE to learn more about CureGN. CLINICAL TRIALS Patient participation in clinical research is essential to advance new treatments. In 2014, NKI launched several new programs to educate patients and increase awareness of opportunities to participate in research. The NEW Clinical Trial Finder website lists 16 studies actively recruiting participants in the US and Canada and another 18 around the world. We launched a Clinical Trial Ambassadors Program to recruit and train volunteers to help educate patients about the benefits (and risks) to participate in clinical trials and educate the medical community about the need for more research into treatments for NS. We posted, tweeted, emailed and sent letters about NEW FSGS drug trials. Our activities have raised awareness for potential participants and increased the interest of biopharmaceutical companies in working with NKI to advance new drug trials. CATALYZE, COLLABORATE AND CONVENE NKI is dedicated to being a catalyst along the research continuum: from support for basic science research to working with the biopharmaceutical industry and the FDA to understand how we might increase the numbers of new drugs moving into the drug approval pipeline and, finally, how to rapidly integrate new treatments into health care practice. 2014 was a busy year as we joined forces with our partners in healthcare and research to promote better treatments and faster cures. The advocacy work of NKI volunteers, staff and our professional partners in Washington, D.C. was instrumental in significant NEW FUNDING for FSGS and NS research in 2014. The National Center for Advancing Translational Sciences (NCATS) at the National Institute of Health (NIH) awarded $10 MM in new funding to continue the Nephrotic Syndrome Study Network (NEPTUNE), a consortium of research centers in the US and Canada collecting and analyzing data about patients newly diagnosed with primary NS diseases. NKI was a principal funder of the first phase of this study and continues to support and participate in its expansion. A second institute in NIH, the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) awarded a new $20 MM, 5- year grant to follow patients with FSGS, Minimal Change Disease, Membranous Nephropathy and IgA Nephropathy. NKI was instrumental in collaborating with NIH to get this funding. Click HERE. For the first time, FSGS is listed as a condition eligible to receive research grants through the Department of Defenses’ Peer-Reviewed Medical Research Program. Because FSGS is listed, FSGS researchers have an opportunity to compete for grants from a NEW funding source. The total amount in the DoD’s program is $247.5 Million! NKI is a leader in assembling, facilitating and promoting professional meetings that bring together partners from industry and the academic world along with patients and their advocates to promote NS health research. In 2014, NKI: Organized the 10th International Podocyte Conference in Freiburg, Germany. This conference brings together researchers from a variety of scientific disciplines and from around the world to promote interactions and new collaborations and to investigate emerging directions in podocyte and glomerular biology research. Convened the PRO in Glomerular Disease Scientific Conference with representatives from academic medical centers, the biopharmaceutical industry, the NIH and the FDA to pursue the development of Patient Reporting Outcome (PRO) instruments to advance new drug trials for FSGS and NS. (A PRO is any report of the status of a patient’s health condition that comes directly from the patient.) An FDA-accepted PRO instrument can accelerate the number of applications to the FDA for new drug trials. NKI continues to lead the development of a PRO development consortium. Convened the third NephCure Research Accelerator Meeting that brought together physicians and scientists with representatives from more than a half dozen biopharmaceutical companies with an interest in drug development for kidney disease. Research Accelerator Meetings were initiated by NephCure to engage these two scientific groups in an exchange of knowledge that will accelerate translation of basic science discoveries to new treatments for people with NS diseases. Presented a session on the NephCure Kidney Network and patient-powered research to the US Summit of Kidney Organizations hosted by the America Society of Nephrologists at its 2014 conference in Philadelphia. NKI continues to be a leader in bringing the voice of patients to the forefront of advocacy for new treatments for chronic kidney diseases such as FSGS, Minimal Change Disease and Membranous Nephropathy.
Precision Medicine Initiative February 4, 2015 by Kylie Karley President Barack Obama announced recently the Precision Medicine Initiative to be included in the 2016 federal budget. This is a bold new enterprise to revolutionize medicine and generate the scientific evidence needed to move more personalize medicine into every day clinical practice. Precision Medicine can be defined as getting the right treatment, at the right time – every time – to the right patient. It is about tailoring treatments “for a person” based on how they experience a medical condition rather than focusing on treating “the disease.” The President’s budget includes support for the FDA to develop new approaches for evaluating next generation genetic screening and the NIH to create research that embraces volunteer participation. There is significant emphasis in this Initiative on engaging people experiencing a health problem in the development of targeted treatments for their condition. Patients should be active partners in the search for new and better therapies and not merely passive recipients of investigational treatments. Dr. Francis Collins, Director of the National Institutes of Health, in a small luncheon following President Obama speech, spoke with great enthusiasm of the need to gain better insights into the biology of all diseases to make a difference for the millions of Americans who suffer from them. He was clear that this initiative must be led by us, the people. He stated, “The word ‘patients’ is not the right one. This is about participants and really about partners.” Dr. Kathy Hudson, Deputy Director for Science, Outreach and Policy at NIH commented, “The Initiative will set the foundation for new ways of engaging research participants, sharing health data and information, and employing technology advances to mine the information for comprehensive results.” NephCure Kidney International is very excited to already be a part of this movement as the NephCure Kidney Network (Patient Registry) is the ONLY kidney disease Patient Powered Research Network in another key government initiative — the Patient-Centered Outcomes Research Network (PCORnet). The NephCure Kidney Network is poised to be at the forefront of integrating new opportunities from the President’s Initiative with new technology and “big data” solutions that will propel new therapies for our patient community. STAND UP & BE COUNTED. Visit https://www.nephcurekidneynetwork.org/ to learn more about participating in the NephCure Kidney Network (Patient Registry) so your voice can be heard and to share your experience to accelerate new therapies and, one day, a cure for FSGS and Nephrotic Syndrome. Contact research@nephcure.org to connect with a member of NephCure’s research team.
2014: The Year in Review December 31, 2014 by Lauren Eva 2014 has come to an end and what a year it has been! We can’t help but look back and reflect on all the changes, including the ups and downs, 2014 brought to us. One of the biggest happenings of the year was our rebranding from the NephCure Foundation to NephCure Kidney International (affectionately known as NKI). As we officially expanded our vision and focused our priorities, we also changed leadership, and welcomed Mark Stone to the role of acting Chief Executive Officer. Under the umbrella of our new identity, we launched the new NKI website, www.nephcure.org. We are thrilled to continue to get feedback from YOU that the site is easy to navigate, informative, and appealing. Keep your comments and suggestions coming! Along with the website launch, we simultaneously released our updated logo and brand. What could be more exciting than all that? Ringing in our new identity, quite literally, during the ceremonious ringing of the opening bell at the New York Stock Exchange on August 15. Internally, we worked smarter – and harder – throughout the year to roll out new programs and update current offerings in the hopes we would better serve you, our community. Highlights include: Reimagining and reformatting our Lunch and Learns. Now called Community Cafes, we’ve condensed and streamlined the timeframe, while also allowing for more time for attendees to interact and ask questions. We are excited to offer more Cafes than ever before in 2015. Envisioning and launching a brand new NephSpace, our online support community for patients, caregivers, family members, and friends of those suffering from Nephrotic Syndrome on a more robust, user-friendly platform. Stop by and say Hi! With your help, our launch of STAND UP & BE COUNTED through social media raised $12,000 in two weeks. Give yourselves a HUGE round of applause. In the fall, we premiered CureMakers, our monthly-giving membership program and welcomed many new members to the NKI family For the first time EVER we held a 24-hour giving campaign on Giving Tuesday, November 25. On that day, each donation made was matched, enabling us to fundraise more than $34,000 in one day. Affirming our commitment to patient-powered research we launched the NephCure Kidney Network (NKN), NephCure’s patient-powered research network, which is a registry of data donated by patients with the diseases that cause primary Nephrotic Syndrome. NKI also provided funding of the CureGN consortium, and presentation of the NKI patient-powered research roadmap during Kidney Week in Philadelphia, Pa. You can now learn more about clinical studies near you with our new, interactive Clinical Research map on www.nephcure.org. Our philosophy and methods involving community fundraising have shifted from a walk-centric model to one that focuses on celebrating the individualism of each family, creating different types of events based on YOUR wants and needs. Our model will now stand to offer fun, soul enriching experiences and foster a sense of community, creating the best environment to raise funds to accelerate finding new treatments and ultimately, a cure. We will sustain this through 2015 with the addition of full-time, regional directors strategically located throughout the US. We celebrated many successful events throughout 2014, including walks, nephletes-sponsored events, community events too numerous to mention, co-hosting the Podocyte meeting in Freiburg, Germany, and another amazing year at the Pig Jig in Tampa, Florida and Countdown to a Cure in NYC. As we look to 2015 and beyond, we look forward to expanding to include new events across the US and internationally. As we bid goodbye to 2014 and welcome 2015 with open arms, we want to say thank you. It is because of you, our patients, caregivers, families and friends, and your constant tenacity in facing adversity, that we are pleased to embrace change. You inspire us. We can’t do this without you. We look forward to continuing this journey with you. Happy New Year!
NephCure Kidney International Announces NKN Steering Committee Co-Chairs October 2, 2014 by Kylie Karley We are pleased to share that Kathleen Broderick and Randall Snyder were recommended and have accepted their nominations as Steering Committee Co-Chairs for the NephCure Kidney Network (NKN). Kathleen was considered a strong candidate due to her dual experience as a patient caregiver as well as a patient advocacy representative. Similarly, Randy’s dual perspective as a patient caregiver and clinical provider give him unique insight relevant to the NKN. Kathleen is a member of the NephCure Board of Directors and Research Committee and an editor at DeGruyter Publishing, a Science, Technology, and Medicine (STM) publisher of professional books and scholarly journals in Boston, Massachusetts. Additionally, Kathleen cares for her 16-year-old son, who was diagnosed with Nephrotic Syndrome at 20 months. Randy is an interventional radiologist with his master’s in molecular biology living in Medford, New Jersey, who cares for his son who was diagnosed with focal segmental glomerulosclerosis. Kathleen and Randy will be facilitating Steering Committee calls and communication moving forward. Please join us in welcoming Kathleen and Randy as the inaugural NKN Steering Committee Co-Chairs!