> Background

Currently more than 17,000,000 people in the United States have chronic kidney disease mostly related to diabetes, obesity, hypertension, viral infections, and complications from commonly used medications. Of these individuals more than 300,000 have reached end stage renal disease (“ESRD”) and are required to undergo dialysis. Over the past decade, the incidence of ESRD has steadily increased. In a substantial number of cases while physicians are able to identify the type of kidney disease a patient may have, they do not understand what triggers the disease or how they can prevent it, and treatment modalities are primitive. The yearly cost to Medicare and Medicaid for dialysis patients exceeds $15 billion. By 2008, the number of patients on dialysis in the USA will exceed 500,000 patients at a projected cost of $23 billion. Sadly, kidney disease has become one of the largest components of total United States health care expenditures.

Only a small number of dialysis patients are fortunate enough to receive a cadaveric or living related kidney transplant. The waiting time for transplant currently exceeds 4 years. The reasons for the progressive rise in the incidence of ESRD are not well established. It is imperative that we gain a better understanding of the mechanisms of renal disease and its progression and develop better tools to diagnose, treat and ultimately prevent these conditions.The duration of life among ESRD patients is substantially reduced. In 1996 the death rate among ESRD patients during the first year of renal replacement therapy was approximately 20%. This was even worse in diabetic patients. Cardiovascular diseases are a leading cause of morbidity and mortality among ESRD patients. Hypertension is considered one of the most common causes of kidney disease and is a critical risk factor for cardiovascular disease in this patient population. Better understanding of the pathophysiology and treatment of kidney disease and hypertension may lead to reducing the progression of renal and cardiovascular disease in this group

In spite of these alarming trends and gigantic cost burdens, the level of basic kidney research nationally is woefully inadequate.