Introduction

The Kidney Precision Medicine Project (KPMP) is a prospective cohort study, whose goal is to use deep molecular phenotypes of kidney biopsies, along with longitudinally collected clinical phenotypic data, in order to develop new disease ontologies, classification systems, and treatments for acute kidney injury (AKI) and chronic kidney disease (CKD).

For each participant, kidney tissue is obtained for molecular phenotyping and clinical diagnosis. In addition to the kidney biopsy tissue, the study collects baseline (time of biopsy) and longitudinal biospecimens (including urine, plasma, serum, DNA, and stool) and demographic, clinical, and laboratory data.

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Participant Population

The KPMP is focusing on participants with acute and chronic kidney disease, who account for a large portion of the public health concern as reported by research and federal data.

CKD

• High priority populations include CKD in the setting of diabetes (diabetic kidney disease, DKD) and hypertension-associated CKD (H-CKD).

DM-R

• A special population of people with long-standing type 1 diabetes (more than 25 years) who remain free of clinically-evident DKD (i.e. diabetes mellitus-resilient (DM-R) individuals also known as “Resistors”) will also be included. Study of the DM-R population using KPMP protocols offers a unique opportunity to identify protective factors against complications of diabetes mellitus.

AKI

• The focus will be on acute intrinsic non-glomerular disease, primarily on acute tubular necrosis (ATN). 

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Inclusion / Exclusion Criteria

Inclusion:

• Diabetic Kidney Disease (Type 1 or 2)
• Hypertensive Kidney Disease
• Acute Kidney Injury
• Patient has had diabetes for many years but no clinical indications of CKD

Exclusion:

• Age (under 18)
• Glomerular disease, kidney transplant, malignancy, pregnancy
• Increased biopsy complication risk

For more specific details regarding inclusion and exclusion criteria for our various study populations, see the full clinical protocol on the KPMP website.

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Cite KPMP in your publications

See: Citing KPMP data

Biopsy Processing and Distribution

The goal for KPMP ideally is to obtain 3 cores from each participant, which allows for multiple -omics technologies to be run on the same participant (though on different core samples). Core 1 is used for diagnostic purposes; Cores 2 and 3 are solely used for research:

For more information about the current triage process for the biopsy cores, see the pathology protocol on the KPMP website.

KPMP Data Types

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Clinical data

A wide variety of clinical phenotype data is being collected about each participant in the KPMP, including longitudinal follow-up data. The KPMP REDCap codebook outlines all of the collected clinical phenotype data. View the REDCap Codebook.

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KPMP has created a baseline clinical phenotyping data file that allows for a faster turnaround time for clinical data requests once a Data Use Agreement (DUA) has been completed. This file can be sent to users both internally and externally with DUAs. Variables include sex, age, race, disease type, condition, KDIGO stage, duration, comorbidities, family and personal history, frequently requested lab values, and medications. To find out more about the contents of this baseline clinical file, view the Baseline Clinical Phenotyping Data Dictionary.

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Pathology data

KPMP biopsy tissue is processed for light microscopy, immunofluorescence microscopy, and electron microscopy. Standard light microscopic stains for the KPMP tissue are: H&E, PAS, trichrome, and Jones' silver. The light microscopy whole slide images are available for download in the Atlas Data Repository (here).

See the pathology protocol for more details on the pathology workflow.

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Molecular data

Several tissue interrogation technologies are active in the KPMP. To maximize impact of the limited kidney tissue, participating sites are required to submit their technology for a review of feasibility, reproducibility, rigor, and value of the technology to achieve the goals of the KPMP. The table below lists all of the omics and imaging technologies that are approved and actively analyzing kidney biopsy tissue. The multimodal techniques applied on KPMP biopsies are expected to evolve over time.

To learn more about each tissue interrogation approach, see the Technologies section.

See all available data in KPMP

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Approved tissue interrogation technologies

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Metadata standards

The Kidney Precision Medicine Project is generating a large amount of data. To enable data accessibility and interoperability, each dataset that is generated must be accompanied by a standard set of metadata. The required metadata properties vary by technology. For the metadata properties being collected for all of the KPMP technologies, refer to the Metadata page to see all of the metadata templates.

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How to cite data used from the KPMP

The following citation must be used when citing KPMP data. KPMP follows the AMA standard for its citations.

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The results here are in whole or part based upon data generated by the Kidney Precision Medicine Project. Accessed Month Day, Year. https://www.kpmp.org.

Funded by the National Institute of Diabetes and Digestive and Kidney Diseases (Grant numbers: U01DK133081, U01DK133091, U01DK133092, U01DK133093, U01DK133095, U01DK133097, U01DK114866, U01DK114908, U01DK133090, U01DK133113, U01DK133766, U01DK133768, U01DK114907, U01DK114920, U01DK114923, U01DK114933, U24DK114886, UH3DK114926, UH3DK114861, UH3DK114915, UH3DK114937)

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NOTE: Remember to replace "Accessed Month Day, Year" with the correct specific details.