To take advantage of the rapidly emerging approaches in genomic medicine to define disease on the molecular level, cohorts of patients with large-scale molecular and clinical data sets on the same individual are be the rate-limiting step. Establishing these cohorts requires a long-term effort, but renal disease offer a unique advantage compared to other chronic diseases as we have access to the primary disease mechanism in humans via renal biopsy and urine derived biofluids.
Technologies are emerging to obtain comprehensive genome wide information spanning genotype, tissue compartment specific epigenetic, transcriptional, proteomic and metabolomic datasets from blood, urine and renal tissue. Matching this information with in vivo imaging, digital histopathology and prospective clinical disease course including drug and environmental exposures can aid to define underlying molecular events of phenotypic measures. Systems biology approaches can be employed across the entire genotype – phenotype continuum to redefine renal diseases on the molecular level and identify the key regulatory hubs most amendable to therapeutic manipulations. These data sets will be a reference base to test novel hypotheses and model systems for human disease relevance.