了解加拿大肾脏疾病的现状以推动精准医学指导下的个性化护理。
Understanding the Current Landscape of Kidney Disease in Canada to Advance Precision Medicine Guided Personalized Care.
作者信息
Kitzler Thomas M, Chun Justin
机构信息
Division of Medical Genetics, Department of Specialized Medicine, McGill University Health Centre, Montreal, QC, Canada.
Department of Human Genetics, McGill University, Montreal, QC, Canada.
出版信息
Can J Kidney Health Dis. 2023 Feb 13;10:20543581231154185. doi: 10.1177/20543581231154185. eCollection 2023.
PURPOSE OF REVIEW
To understand the impact of kidney disease in Canada and the priority areas of kidney research that can benefit from patient-oriented, precision medicine research using novel technologies.
SOURCES OF INFORMATION
Information was collected through discussions between health care professionals, researchers, and patient partners. Literature was compiled using search engines (PubMed, PubMed central, Medline, and Google) and data from the Canadian Organ Replacement Register.
METHODS
We reviewed the impact, prevalence, economic burden, causes of kidney disease, and priority research areas in Canada. After reviewing the priority areas for kidney research, potential avenues for future research that can integrate precision medicine initiatives for patient-oriented research were outlined.
KEY FINDINGS
Chronic kidney disease (CKD) remains among the top causes of morbidity and mortality in the world and exerts a large financial strain on the health care system. Despite the increasing number of people with CKD, funding for basic kidney research continues to trail behind other diseases. Current funding strategies favor existing clinical treatment and patient educational strategies. The identification of genetic factors for various forms of kidney disease in the adult and pediatric populations provides mechanistic insight into disease pathogenesis. Allocation of resources and funding toward existing high-yield personalized research initiatives have the potential to significantly affect patient-oriented research outcomes but will be difficult due to a constant decline of funding for kidney research.
LIMITATIONS
This is an overview primarily focused on Canadian-specific literature rather than a comprehensive systematic review of the literature. The scope of our findings and conclusions may not be applicable to health care systems in other countries.
综述目的
了解肾脏疾病在加拿大的影响,以及肾脏研究的重点领域,这些领域可受益于以患者为导向、运用新技术的精准医学研究。
信息来源
通过医疗保健专业人员、研究人员和患者伙伴之间的讨论收集信息。利用搜索引擎(PubMed、PubMed中央数据库、医学在线数据库和谷歌)以及加拿大器官移植登记处的数据汇编文献。
方法
我们回顾了加拿大肾脏疾病的影响、患病率、经济负担、病因以及重点研究领域。在回顾肾脏研究的重点领域后,概述了未来研究的潜在途径,这些途径可将精准医学举措整合到以患者为导向的研究中。
主要发现
慢性肾脏病(CKD)仍然是全球发病和死亡的主要原因之一,给医疗保健系统带来巨大经济压力。尽管CKD患者人数不断增加,但基础肾脏研究的资金仍落后于其他疾病。目前的资金策略倾向于现有的临床治疗和患者教育策略。在成人和儿童人群中确定各种形式肾脏疾病的遗传因素,为疾病发病机制提供了机制性见解。将资源和资金分配到现有的高收益个性化研究项目中,有可能显著影响以患者为导向的研究结果,但由于肾脏研究资金持续下降,这将面临困难。
局限性
这是一篇主要关注加拿大特定文献的综述,而非对文献的全面系统评价。我们的研究结果和结论范围可能不适用于其他国家的医疗保健系统。
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N Engl J Med. 2021-10-28