Kidney Disease Aging Research Collaborative (KDARC) Research Infrastructure to Advance the Science of Geriatric Nephrology

Kidney Disease Aging Research Collaborative (KDARC) will address a fundamental challenge in nephrology by establishing infrastructure to support sustainable interdisciplinary research on the science of aging. Although kidney disease occurs in ~40% of older (aged≥65 years) adults, among whom up to 70% are frail and 87% have cognitive impairment, adult nephrology care ascribes to a “one size fits all” approach ignoring geriatric syndromes. As noted by the National Academies of Science, Engineering, and Medicine there is a significant age disparity in accessing the preferred forms of kidney disease treatment. These age disparities are driven by the dearth of research on kidney disease patients with geriatric syndromes. In contrast to the 18,200 general nephrology publications, only 183 geriatric nephrology manuscripts have been published since 2000. Consequently, there is wide variation in choice of geriatric tools in clinical practice and research. Geriatric nephrology research is limited by 3 major barriers: 1) organizational barriers that dissuade interinstitutional collaborations, 2) data barriers that leave pressing research questions unanswered, and 3) workforce development barriers that limit entry into the field. To advance and sustain the science of aging in nephrology, novel research infrastructure that address these barriers and supports faculty who are early career and/or new to aging research are critically needed. Therefore, we have taken the first steps to establish a new geriatric nephrology research collaborative, KDARC and identified 3 geriatric nephrology research priorities. We will establish a robust and sustainable infrastructure in KDARC through a Development Phase (R61) and Application Phase (R33); progress will be guided by an experienced Oversight Board and monitored by yearly milestones. R61 Specific Aims, Development Phase: 1. Formalize KDARC organizational structure and procedures (Year 1-2); 2. Convene a consensus conference on geriatric nephrology research priorities (Year 2); and 3. Establish KDARC Data Cooperative with existing data (Years 1-2). R33 Specific Aims, Application Phase: 1. Enable KDARC investigators to launch new geriatric nephrology studies (Year 3); 2. Support geriatric nephrology pilot studies (Year 3-4); and 3. Advance geriatric nephrology research skills (Year 3-5). KDARC will establish the necessary research infrastructure to stimulate new interdisciplinary research in aging and kidney disease by leveraging existing datasets, formalizing new data collection for preliminary data, and investing in the career development of its members. KDARC resources will be widely available to the broader research community. Ultimately, KDARC will produce critically needed high-impact and high-priority geriatric nephrology research that will reduce well-recognized age disparities in nephrology and positively impact the lives of the 22.4 million older adults living with kidney disease in the US.