KPMP in Type 1 Diabetes: A UW Medicine Collaboration

Project Summary This project will establish a Type 1 Diabetes (T1D) Recruitment Site within the Kidney Precision Medicine Project (KPMP) at the University of Washington. We bring substantial experience conducting kidney biopsies among people with T1D, having already completed >130 biopsies as part of multiple successful T1D studies. Building on established infrastructure for patient-oriented research in T1D, we will obtain research kidney biopsies and comprehensive phenotyping from individuals with T1D who have or are at risk of chronic kidney disease (CKD). Our specific aims are to: (1) safely and ethically obtain research kidney biopsies from adults and adolescents living with T1D who have or are at risk of CKD through robust community engagement and standardized protocols; (2) robustly phenotype the clinical presentation through advanced imaging (multiparametric kidney MRI, retinal imaging) and vascular assessment; and (3) actively contribute to enhanced understanding of CKD pathophysiology through collaborative participation in KPMP team science. We will integrate expertise from two premier research centers - the University of Washington Medicine Diabetes Institute (UWMDI) and Kidney Research Institute (KRI) - to enroll 15-20 participants annually. Starting in Year 2, pending careful ethical consideration with patients and the broader KPMP consortium, we propose expanding enrollment to include adolescents ≥16 years. Together, this work will advance understanding of kidney disease in T1D while maintaining the highest standards of patient safety and ethical conduct. By integrating with KPMP’s existing infrastructure and protocols, our site will contribute to the development of precise, mechanistic definitions of kidney disease in T1D, ultimately enabling more targeted diagnosis and treatment.