Abstract

Diabetic kidney disease (DKD) is the leading cause of end stage renal disease (ESRD), and its global incidence and prevalence have reached epidemic dimensions in recent years. Unfortunately, there are no effective means to prevent or cure DKD. Apart from Renin-Angiotensin-Aldosterone System (RAAS) blockade, which has limited effects, very few alternative therapies have emerged. Lack of predictive and prognostic biomarkers for a more accurate patient stratification, limited access to kidney tissue from patients at various stages of DKD and to appropriate model systems to better understand the pathogenesis of the disease, are likely reasons for the stagnating development of new treatments. The BEAt-DKD consortium combines outstanding basic and translational researchers in nephropathy, diabetes, kidney model systems, imaging techniques and systems biology, and includes leaders of diabetes and kidney disease-relevant IMI-1, FP7 and US consortia, like SUMMIT, KIDNEYCONNECT, Syskid, CPROBE and C-Path, in an unprecedented search for new and better biomarkers for DKD, through better understanding of the disease. Jointly, the partners have access to vast and very relevant clinical cohorts and trials, state-of-the-art analysis and imaging techniques, novel model systems and the long-standing experience and networks to make this collaboration a success. By involving regulatory agencies throughout the project, BEAt-DKD aims at making the introduction and acceptance of new tools as efficient as possible. The overall goals of BEAt-DKD are (1) to provide a holistic systems medicine view of the pathogenesis of DKD with the aim to identify targetable mechanisms and pathways underlying initiation and progression of DKD, applying a novel sub-classification of diabetes, and (2) to identify and validate biomarkers of disease progression and treatment responses representing first steps towards precision medicine in the management of DKD.