Epidemiology research to foster improvement in chronic kidney disease care.

Abstract

With the increasing availability of linked electronic health records, long-running cohorts, and high-throughput technologies, the potential for epidemiology research to improve the care of patients with kidney disease is greater than ever before. In this review, we highlight the application of epidemiology techniques to identify, evaluate, and address chronic kidney disease. We discuss studies that inform guidelines, identify health disparities, evaluate the genetic basis of disease, and relate data on omics, such as proteomics, metabolomics, and genetics, to outcomes. We describe how observational data have been used to facilitate the conduct of randomized controlled trials through enhanced identification of high-risk individuals and the evaluation of surrogate kidney disease outcomes as well as to address clinical questions where randomized controlled trials are impractical or infeasible. Finally, we discuss consumer engagement in research, including that of patients, policymakers, payers, and health care system, and the role of kidney disease epidemiology research in implementation science and as a key source of data and methodology for precision medicine.