Supporting PhD Scientists to Help Drive Breakthroughs, Improve Care

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Accelerating innovation depends on a strong foundation of basic science. Any progress at the bedside builds on discoveries in the lab, and these breakthroughs require supporting PhD scientists, securing funding, and strengthening the infrastructure. Even with its increased focus on clinical nephrology during the last decade, ASN has never wavered in its 60-year commitment to researchers and scientists, especially those focused on basic investigation like many PhD scientists.

Before highlighting ASN’s efforts to support PhD scientists, it is important to note that the greater focus on clinical nephrology has produced extraordinary results. If ASN Excellence in Patient Care were a separate organization, it would be one of the largest medical specialty societies representing US nephrologists (1). Despite “a dramatic productivity decline relative to previous years” of legislation being passed in Congress (2), this emphasis on clinical nephrology also helped produce incredible wins last year—especially related to transplant policy (3).

In 2024, ASN will continue to advocate for:

• Intervening earlier to prevent, diagnose, coordinate care, and educate

• Transforming transplant and increasing access to donor kidneys

• Accelerating innovation and expanding patient choice (including more access to home dialysis)

• Achieving equity and eliminating disparities

• Bolstering the kidney health professional workforce

To help guide these efforts, ASN welcomed three newly elected members to its nine-member governing board on Monday, January 1, 2024. Jeffrey H. Miner, PhD, FASN, will serve a 4-year term on the ASN Council as treasurer; Samir M. Parikh, MD, FASN, joined the council as secretary (and will serve as the society’s president in 2026); and Daniel E. Weiner, MD, MS, FASN, will serve as one of the society’s four at-large councilors through 2027.

As an elected member of both The American Society for Clinical Investigation and the Association of American Physicians, Parikh has demonstrated a career-long commitment to research. Weiner—the founding editor-in-chief of Kidney Medicine and ASN’s representative to Kidney Care Partners (a community-wide advocacy coalition that supports increased federal funding for kidney research)—is an expert in the many policy processes needed to advance discovery and improve care.

Miner is the first PhD scientist to serve on the ASN Council since Diana Marver, PhD (1993–1995), who followed James A. Schafer, PhD (1990–1992), and Ruth Bulger, PhD (1985–1987). Four MD-PhDs have served or are currently on the council: George E. Schreiner, MD, PhD (1968–1972); Juha P. Kokko, MD, PhD (1979–1986); Joseph V. Bonventre, MD, PhD, FASN (2006–2012); and Prabir Roy-Chaudhury, MD, PhD, FASN (2019–2026), who will serve as ASN president in 2025.

In June 2013, Miner chaired ASN’s first-ever PhD Summit (4) to identify ways for the society to generate more interest among current and future PhD scientists regarding the study of the normal and diseased kidney and to ensure that ASN is meeting the needs of its PhD members. Approximately 7% of ASN members are PhD scientists, and they conduct basic, translational, clinical, and epidemiological research, contributing across the continuum.

When compared with nephrology, PhD scientists in most other specialties receive greater funding from the National Institutes of Health (NIH) because they submit more grant applications than do MDs (or other physicians with equivalent degrees) or MD-PhDs (5). The NIH and the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) are pay-line driven; that is, more applications typically result in more funding. As such, specialties with more PhD scientists submitting applications have an advantage over specialties with fewer PhD submissions—like nephrology.

Across the NIH, PhD scientists submit approximately 70% of applications, whereas MDs submit approximately 15% of applications (5). In contrast, PhD scientists typically submit just 50% of applications for kidney research funding from the NIDDK (Table 1) (6). The kidney community is fortunate to have so many physicians engaged in research. ASN must do everything possible to support them, especially as interest in nephrology fellowship training declines, and other challenges discourage nephrologists from research careers.

Table 1

Unique applicant summary for NIDDK's Division of Kidney, Urologic, and Hematologic (KUH) Diseases in fiscal year 2023

View Table

However, these trends also suggest an opportunity to recruit more PhD scientists into kidney research. If successful, such recruitment should lead to more grant submissions—and, therefore, funding—for kidney research.

The ASN PhD Summit resulted in several recommendations to address these and other concerns for advancing PhD interest in kidney research and improving the environment for PhD members of the society. Resulting in at least 10 improvements to ASN, the summit has served to change the society’s culture. Since 2013, ASN’s leadership and staff have attempted to include current and future PhD scientists in every aspect of the society and the broader ASN Alliance for Kidney Health (7).

As a result of the ASN PhD Summit, the approved improvements:

1. ASN’s travel support opportunities for trainees to include future PhD scientists. These opportunities for medical students, residents, fellows, and PhD candidates include ASN Kidney STARS (Students and Residents); the Karen L. Campbell, PhD, Travel Support Program for Fellows; and the William E. Mitch, III, MD, FASN, International Scholars Travel Support Program. In 2023, ASN supported 66 current and future PhD scientists to attend Kidney Week.

2. Invited future PhD scientists and first-year postdoctoral fellows to participate in the ASN Kidney TREKS (Tutored Research and Education for Kidney Scholars) Program. Last year, 14 future PhD scientists and first-year postdoctoral fellows participated in Kidney TREKS, a program that fosters interest in careers in nephrology and research through a week-long research course retreat and long-term mentorship program. Kidney TREKS includes two locations: the MDI Biological Laboratory in Bar Harbor, ME, and The University of Chicago in Chicago, IL.

3. Established the KidneyCure (the ASN Foundation for Kidney Research) Pre-Doctoral Fellowship Program. Since 2018, KidneyCure has funded 22 PhD students to conduct original research projects. This program fosters graduate students on a PhD track who are highly motivated to make contributions to the understanding of kidney biology and diseases under the direction of a sponsor. Kurt Amsler, PhD, and Ambra Pozzi, PhD, DrPH, are to be commended for their efforts in establishing this important program.

4. Ensured that PhD scientists can compete for KidneyCure funding. Each year, KidneyCure supports the Ben J. Lipps Research Fellowship Program and the Transition to Independence Grants Program to fund nephrology fellows and early-career investigators, respectively. Together, these two programs support approximately 20 new and 20 continuing grants each year. Since 2013, 59 PhD scientists have received these grants from KidneyCure (21 Ben J. Lipps Research Fellows and 38 Transition to Independence Grants Recipients).

5. Applied efforts to promote diversity, equity, and inclusion for PhD scientists. KidneyCure partners with the Robert Wood Johnson Foundation to support the Harold Amos Medical Faculty Development Program Award. This award aims to increase diversity among future leaders in nephrology by supporting the research and career development of a kidney scholar and future health care leader from a historically disadvantaged background. Additionally, ASN provides travel support for its members to participate in the Network of Minority Health Research Investigators (NMRI) Annual Workshop, which is supported by the NIDDK. On average, 35% of the NMRI Annual Workshop participants funded by ASN are PhD scientists.

6. Created a more welcoming environment for PhD scientists at ASN Kidney Week. As the world’s premier nephrology meeting, Kidney Week tries to balance three priorities: showcasing cutting-edge science in nephrology and beyond, inspiring high-quality kidney care for the more than 850 million people worldwide living with kidney diseases, and offering a convivial environment for the kidney community and everyone committed to a world without kidney diseases. PhD scientists are interested in all three facets, and ASN works to increase the relevance of Kidney Week by supporting the Advances in Research Conference (ARC) as an early program, providing travel support for future PhD scientists to attend ARC, and providing numerous educational sessions during the meeting.

7. Reorganized ASN to create a focus on research, discovery, and innovation that includes KidneyCure, the Kidney Health Initiative (KHI), and the Kidney Innovation Accelerator (KidneyX). As a result of this focus, ASN now offers a home for PhD scientists, much like what is available to clinically focused nephrologists through ASN Excellence in Patient Care. In addition to KidneyCure funding available to PhDs, ASN Research, Discovery, and Innovation engages researchers and scientists through KHI’s many projects to “catalyze innovation and the development of safe and effective patient-centered therapies for people living with kidney diseases” (8) and KidneyX’s efforts to “support innovation,” “advance solutions” (including an artificial kidney), and “build community” (9).

8. Revised ASN’s bylaws to create distinct paths for serving on the ASN Council. As recommended by the PhD Summit in 2013—and to make the ASN Council more diverse, equitable, and inclusive—the society revised its bylaws in 2016. This revision resulted in expanding the number of pathways to the council from two (being elected to serve a 7-year term that included 1 year as president or being elected to serve a renewable 3-year term as treasurer) to three (establishing non-renewable, 4-year terms for executive councilors, treasurers, and at-large councilors).

9. Collaborated with other entities that focus on basic science. ASN supported the American Physiological Society Control of Renal Function in Health and Disease Conferences in 2019 and 2022. ASN will partner this year with The University of Alabama at Birmingham (UAB) for the CRRT (Continuous Renal Replacement Therapy) Academy as well as with UAB and Children’s of Alabama for the inaugural International Neonatal Nephrology Symposium. In 2025, ASN will administer the Acute Kidney Injury: From Bench to Bedside Conference. The society is currently negotiating to hold a joint international conference in 2026 for early career investigators.

10. Advocated for more federal research funding to improve kidney health. In addition to individual efforts to advocate for more federal funding—particularly for the NIDDK—ASN actively participates in at least 11 advocacy coalitions (in alphabetical order): The Ad Hoc Group for Medical Research; Coalition for Health Funding; Coalition for Kidney Health; Friends of the Agency for Healthcare Research and Quality; Friends of (the Department of Veterans Affairs) VA Medical Care and Health Research; Friends of the NIDDK; Friends of the National Institute on Aging; Kidney Care Partners; National Heart, Lung, and Blood Institute Constituency Group; National Institute of Arthritis and Musculoskeletal and Skin Diseases Coalition; and Research!America.

Despite all this progress, ASN failed to accomplish at least two recommendations from the PhD Summit. First, ASN has not managed to collaborate with the biotechnology, medical device, and pharmaceutical industries to establish an industry PhD fellowship, in conjunction with academia or government programs (4, 10). Because one of the goals in ASN’s current strategic plan is to build “research readiness, inclusiveness, and translation in kidney medicine, which requires championing clinical trials” (7), perhaps an opportunity exists to combine this goal with the summit recommendation.

Second, ASN has not managed to institute an ASN-designated research center recognition program (similar to the National Cancer Institute’s Comprehensive Cancer Center) (4, 10). In 2017, the Infectious Diseases Society of America (IDSA) launched the Antimicrobial Stewardship Centers of Excellence Program to promote “excellence in antimicrobial use and combating antimicrobial resistance by recognizing hospitals that effectively demonstrate excellence in this work” (11). To date, 177 programs have received the “Centers of Excellence” designation from IDSA. Even though this program is more clinically focused, it could serve as a potential model for ASN.

ASN’s effectiveness comes from balancing all components of its mission to “elevate care by educating and informing, driving breakthroughs and innovation, and advocating for policies that create transformative changes in kidney medicine throughout the world” (7). For the past decade, ASN deepened its commitment to PhD scientists to help drive breakthroughs and innovation. This focus has produced remarkable results for ASN, researchers and scientists, and—most importantly—the more than 850 million people worldwide living with kidney diseases.