RENAL7: Unmet Needs In Nephrology: Survey Results to Drive Innovation

Abstract

Background: Renal Disease is an increasing cause of morbidity and mortality in the U.S. and around the world. Despite advances in diagnosis and therapy, as well as improvements in care technology, long-term outcomes for renal disease patients remain suboptimal. Innovation, as a science and methodology, is focused on developing solutions for advancement beyond the status quo. Central in innovation, is clear identification of opportunities for improvement. In medicine the main driver of innovation is the unmet need. We conducted a survey to identify unmet needs in Nephrology. Here we report on the results. Methods: A multi-question survey was developed by a team of practicing academic nephrologists, biomedical scientists, and innovators. The survey was distributed across the U.S. to practicing academic and non-academic nephrologists. The survey was web-based. The survey collected information on participants’ identification of unmet needs, barriers to achieving solutions to needs, and suggestions for improvement of current therapeutics and technology. Survey questions ranged from more general to specific, also addressing the specific topics of: hemodialysis, interventional nephrology, and transplantation. Results: A broad group of nephrologists responded to the survey from across the U.S. 76 % of respondents felt that Nephrology lags behind other specialties regarding innovation. In the general questionnaire, participants felt that treatment of inflammation and cardiac complications were the most significant unmet needs. The need to develop a bioartificial kidney for patients on hemodialysis was the most significant future need, recognized by 53.5% of respondents. Interestingly, at the same time, respondents felt that technical challenges and lack of investment might limit artificial kidney development. For interventional nephrology, 26% thought creating an AV fistula, which matures fast, is the most significant need. The availability of living donors was the most critical unmet need in transplantation. Conclusion: A broad survey of unmet needs was conducted across the U.S. which revealed a perspective of opportunity. Nephrology was generally felt to have lagged somewhat compared to other medical subspecialties. It was recognized however that there are unmet needs, many of which are ripe for incremental innovation; though some opportunities for revolutionary innovation exist as well. Through further analysis of this data details of specifics will provide starting points for the advance of nephrology into the future.