VA Funds New Kidney Studies that Will Use Million Veteran Program Data

The Department of Veterans Affairs (VA) has funded four grants that will serve as pioneers in using data from the VA’s Million Veteran Program (MVP), a major step in the VA’s effort to advance precision medicine. The four funded grants will answer key questions about heart disease, kidney disease, and substance use.

The MVP has enrolled more than 400,000 veterans so far and has become the largest US database linking genetic, clinical, lifestyle, and military exposure information. The VA’s electronic medical records, which contain longitudinal clinical information, laboratory data, and pharmacy files, will help make this initiative invaluable for carefully delineating phenotypes and medication exposure.

The MVP, which will include understudied African American and Hispanic veteran populations, ties into the broader national Precision Medicine Initiative announced by President Obama earlier this year.

For the MVP pioneer grants, consortia of VA researchers and collaborators from major academic centers will explore specific questions related to chronic illnesses commonly seen among veterans. They will help to establish new methods for securely linking MVP data with other sources of health information, including non-VA sources such as the Centers for Medicare & Medicaid Services (CMS).

Adriana Hung, MD, a dual-appointed VA and Vanderbilt University Medical Center (VUMC) investigator with a background in pharmacoepidemiology and genetics, will be principal investigator for one of the grants to study kidney disease. Dr. Hung has a longstanding interest in metabolic complications of kidney disease and has assembled a diverse group of investigators to study the genetic factors that may influence renal outcomes in high-risk populations. The grant includes three areas of study:

  • pharmacogenomics of diabetic management
  • genetic risk factors for hypertension and associated kidney disease
  • pharmacogenomics of immunosuppressive drugs used in kidney transplantation

Dr. Hung will lead the arm examining how patients with diabetes mellitus respond differently to the drug metformin, the standard first-line treatment for diabetes, based on their genetic profile.

The second area of study will look at the genetics of hypertension, a major risk factor for kidney disease. Key contributors to this arm are Csaba Kovesdy, a nephrologist and epidemiologist at the Memphis, TN, VA and the University of Tennessee Memphis School of Medicine, and Todd Edwards, MD, a genetic epidemiologist at Vanderbilt University, Nashville, TN. Dr. Edwards is principal investigator for a consortium meta-analysis of blood pressure in an African American ancestry cohort (COGENT).

The third arm will study the pharmacogenomics and short- and long-term metabolic complications of tacrolimus in patients who have received a kidney transplant. Kelly Birdwell, MD, a transplant nephrologist and pharmagenomics expert in Nashville, TN, will be a key contributor to this portion of the award.

Finally, Christianne Roumie, MD, an expert in pharmacoepidemiology; Jeffrey Smith, MD, an expert in medical genetics; and Michael Matheny, MD, MPH, an expert in bioinformatics, all from the VA Tennessee Valley Healthcare System and VUMC, will also participate in the project. The goal of this team of investigators is to aid in the MVP’s overarching goal of creating highly accurate phenotypic data that can be used for future investigations to advance precision medicine, in this case for the care of patients at risk for or with chronic kidney disease.