Development of a Biobank of Human Diabetic Nephropathy
Diabetic nephropathy is the leading cause of chronic kidney disease, and is increasing both in the US and worldwide. There is lack of knowledge of the range of lesions that may develop in diabetic patients who do not present with the atypical features that result in renal biopsy. In the modern era of ACE inhibitor treatment, there is limited information on the structural changes that occur in diabetic patients with or without diagnosed nephropathy except for rare protocol biopsies related to entry points for clinical trials, and classic autopsy studies. Further, application of novel methods of analysis, including non-biased proteomic approaches, linked to sophisticated and detailed morphologic and morphometric analyses, with linkage to functional changes in patients, is lacking. However, it is not feasible or ethical to biopsy diabetic patients where there is no clinical indication and they are not part of a clinical trial. In this pilot project, we propose a novel strategy to bridge this gap in knowledge, by developing a system that will allow allocation of portions of tissue obtained from tumor nephrectomy specimens and at autopsy, and then linking these samples to a de-identified electronic medical record (EMR). This pilot will build on the existing BioVU project, which currently links blood DNA samples to patient de-identified synthetic EMRs. The availability of this tissue along with the DNA from diabetic and non-diabetic patients who opt into the BioVU system will provide detailed longitudinal clinical data and will provide an exceptional tool for such dedicated studies over the course of diabetic nephropathy and in diabetic patients without overt nephropathy and in non-diabetic patients as controls. Furthermore, any correlations of phenotypic and genomic signals obtained from these samples can be further queried using the repository of existing DNA samples of patients carrying the diagnosis of diabetic nephropathy in the BioVU repository. Thus, our pilot study will test feasibility of this approach, with potential to create an exceptional data bank of a variety of tissues remaining from various surgical pathology specimens and at autopsy.

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