Chronic kidney disease (CKD) including end stage renal disease (CKD stage 5) is a major health problem in sub-Saharan Africa (SSA) affecting more than 50 million individuals but there is lamentable lack of research data and there is no promise of urgently needed preventative strategies. The lack of data on CKD in SSA are in part due to the absence of population-based epidemiologic studies of CKD and a scarcity of physician scientists conducting genetic, clinical and translational research on CKD according to local priorities. Herein, we propose to leverage the H3Africa Kidney Disease Research Network (H3A-KDRN) to (i) conduct genomics, clinical and translational research on the most prevalent forms of CKD; (ii) expand and support a well-trained cadre of African researchers and physician scientists to conduct CKD research according to regional priorities; (iii) engage SSA communities and research participants in the initiation, governance, implementation and dissemination of CKD research and (iv) foster collaboration with U.S.-based basic, clinical and translational researchers (including Africans in the diaspora) to elucidate etiologies and mechanisms and discover effective therapeutic and preventative strategies to combat the extraordinary burden of CKD in people of African ancestry globally The H3A-KDRN is organized as a research consortium initially composed of: (a) 15 academic medical centers/university teaching hospitals in five African countries- Cameroon - 1, Ghana ? 4, Nigeria ? 8, South Africa - 1 and Tanzania ? 1; (b) 9 North American/Israeli research intensive academic medical institutions; (c) 3 shared cores ? Training and Career Development, Data Management and Biostatistics and Genotyping Laboratories. At the end of the five-year funding requested in this application, The H3AKDRN will have accomplished the following: 1. Completion of three research projects on: (i) CKD in HIV-infected patients; and (ii) childhood and adolescent onset nephrotic syndrome and (iii) sickle cell disease nephropathy. These three prospective cohort studies will have a total sample size of 5800 participants. 2. Completion of training of four African-based research scientists toward PhD (n=2) and MSc (n=1) in Clinical and Translational Science (CTS) awarded by the University of Arizona 3. Completion of certificate training in clinical research methods for 45 African-based research personnel 4. Establish a high functioning regional Clinical and Translational Research Coordinating Center to support multicenter research in CKD and other non-communicable chronic diseases in SSA. With these foundational objectives, the H3Africa Kidney Disease Research Network will a transformative impact on CKD research in SSA and thence move us closer to the goal of reducing the burden of CKD in the 352 million Africans living in the five H3A-KDRN countries and in the 1.2 billion people of African descent globally.

Public Health Relevance

More than 50 million people in sub-Saharan Africa have chronic kidney disease (CKD) making the Africa the continent with the greatest burden of CKD in the world. The training of researchers and the three research projects on CKD to be conducted on 5,800 individuals as proposed in this application will yield clinical and genetic information that will advance our understanding of the causes of CKD in patients with human immunodeficiency virus infection, children with nephrotic syndrome and patients with sickle cell disease. The research findings will also lay the foundation upon which to develop new treatments and strategies to prevent CKD.

National Institute of Health (NIH)
National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK)
Specialized Center--Cooperative Agreements (U54)
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Special Emphasis Panel (ZHG1)
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Parsa, Afshin
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College of Health Sciences, University of Ghana
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