When a novel coronavirus emerged in late 2019, everyone risked infection, but kidney patients found themselves especially vulnerable. People with kidney disease have compromised immune systems and the vast majority of these individuals—roughly half a million people—must visit dialysis centers several times a week, exposing themselves to contact with staff and other patients when they should ideally be isolated at home.
“The vulnerability of this population is underappreciated,” says John Sedor, MD, FASN, chair of KidneyX, the Kidney Innovation Accelerator, a public-private partnership between ASN and the U.S. Department of Health and Human Services. The initiative aims to accelerate innovation in the prevention, diagnosis, and treatment of kidney diseases—ultimately creating a new kidney care paradigm that is far less reliant on in-center dialysis. “COVID-19 has raised the stakes to try to have innovations ready for regulatory review in a year or two, maybe three,” Sedor says.
Through a series of prize competitions, KidneyX engages researchers, innovators, and investors in the development of breakthrough therapies. The initiative’s inaugural prize competition asked participants to conceptualize ways to replicate normal kidney functions and improve patients’ quality of life. Phase 2 of the competition asks applicants to build and test prototypes that can transform the status quo. While that work is ongoing, the COVID-19 pandemic ups the urgency of developing novel therapies.
“People have been working with this idea that we need to accelerate innovation for quite a long time,” says Sedor, a professor in molecular medicine at the Cleveland Clinic Lerner College of Medicine who also holds an endowed chair in kidney research. “Certainly, past natural disasters, coupled with the general need to increase the awareness of the burdens of kidney disease, prompted early efforts to bring innovative strategies to the care of people with kidney diseases.”
The COVID-19 pandemic has underscored the need to redouble efforts. The mainstream press is covering the impossibility of achieving social distancing recommendations in dialysis centers, a situation which leaves already vulnerable people more susceptible to coronavirus infection. The impact of the coronavirus on organs outside the lungs has also made headlines. Acute kidney injury, first observed in infected patients in China, appears to be present in many patients with severe enough illness to warrant intensive care. This has added to the already daunting challenge of providing adequate kidney replacement therapy to patients with chronic kidney disease who have been hospitalized with COVID-19.
ASN is asking Congress to appropriate $200 million for KidneyX in the next COVID-19 relief package to spur the development of a wearable or potentially implantable artificial kidney. “Even a truly portable kidney would make a difference,” says Sedor. “It would be applicable, not only to another pandemic, but to any disruption that prevents people from accessing their life-saving kidney replacement therapies.”
Ideally, he hopes for the development of a technology that would be affordable and available across the globe. That would be a gamechanger—not just in times of pandemic, but for the 850 million people throughout the world whose daily lives are affected by kidney disease.
ASN members are encouraged to contact their Congressional delegation to share the share the unique challenges COVID-19 poses to people with kidney diseases and ask for further investment in KidneyX to safeguard the nation’s kidney health against future pandemics.