ABSTRACT The overarching objective of this KPMP Central Hub application is to create and support a collaborative environment committed to promoting participant safety, scientific rigor, patient engagement, high ethical standards, inclusivity, and the interdisciplinary team science necessary to result in major advances in kidney precision medicine. The Central Hub will coordinate the KPMP Recruitment Sites, Tissue Interrogation Sites, and Opportunity Pool research groups; engage the broader patient, clinical, and research communities; and partner with the Kidney Tissue Atlas Coordinating Center to securely, efficiently, and transparently deliver Findable, Accessible, Interoperable, and Reusable data to these communities. Our experienced multidisciplinary team was instrumental in building the infrastructure and functional ecosystem needed to launch and maintain the first phase of the KPMP. We will build on this experience to provide scientific, technical, administrative, operational, and logistical support to pursue the following specific aims: (1) coordinate ethical, safe, and rigorous implementation of KPMP protocols and procedures; (2) support the collection and distribution of high-quality data and samples with rigorous quality assurance and quality control; (3) build, support, and maintain an inclusive, collaborative culture within KPMP that continuously honors and values the contributions of study participants; and (4) foster external collaborations and catalyze new partnerships through an Opportunity Pool of funds dedicated to maintaining KPMP dynamism.

NARRATIVE Chronic kidney disease (CKD) and acute kidney injury (AKI) are common, heterogeneous, and morbid diseases. Mechanistic characterization of CKD and AKI in patients may facilitate a precision-medicine approach to prevention, diagnosis, and treatment. The KPMP aims to ethically and safely obtain kidney biopsies from participants with CKD or AKI; create a reference kidney atlas; characterize disease subgroups to stratify patients based on molecular features of disease, clinical characteristics, and associated outcomes; and identify critical cells, pathways, and targets for novel therapies and preventive strategies.