Background & Purpose

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PURPOSE

JDRF is the world’s leading non-profit organization with the mission to accelerate life-changing breakthroughs to cure, prevent and treat type 1 diabetes (T1D) and its complications. To this end, JDRF is soliciting letters of intent for therapeutic strategies to prevent or delay progression of diabetic nephropathy (DN) at the earliest possible stages.

BACKGROUND

Diabetic nephropathy develops in approximately 30% of individuals with T1D and is the leading cause of mortality in this population. While there are encouraging signs that end-stage renal disease (ESRD) may be declining, this seems to reflect better glucose control and slower progression of established DN rather than prevention of early DN per se. Indeed, the majority of patients succumb to cardiovascular disease before needing kidney replacement therapy – underscoring the critical need for effective interventions at the earliest stages in people with T1D, well before the onset of ESRD.

The mortality risk from DN can be substantially reduced with improved management of glucose control, blood pressure and other cardiovascular risk factors, such as lipids. However, optimal control does not abolish the risk and novel therapeutic strategies are critically needed. Furthermore, only about one-fifth of people with T1D are achieving recommended glucose control targets.

DN is characterized by a long clinically silent period without signs or symptoms of disease. By the time clinical manifestations such as micro- or macroalbuminuria or GFR decline becomes apparent, renal structural changes are well established. As such, disease-modifying interventions are needed at the earliest stages when these lesions might be most responsive to therapy.