Over the past decade, the research community within Nephrology in Canada has been developing the necessary capacity to support initiatives to enhance the care of chronic kidney disease (CKD) patients. Recognizing that challenges exist in caring for patients with CKD, including the absence of an active knowledge translation plan within Canadian Nephrology and the paucity of relevant clinical trials to guide therapy in many areas, there have been commitments to improving capacity through 2 conferences: Horizons 2000 and Horizons 2015. These Horizons conferences represented a joint initiative of key organizations including The Kidney Foundation of Canada (KFOC), the Canadian Society of Nephrology (CSN), the Canadian Society of Transplantation (CST), and the Canadian Institutes for Health Research (CIHR). Their purpose was to consult with key stakeholders in the kidney research community on the development of a national, strategic research agenda for kidney disease in Canada.
At the Horizons 2000 meeting, participants agreed to develop a transdisciplinary, translational research training program to enhance capacity for kidney research in Canada. The Kidney Research Scientist Core Education and National Training Program (KRESCENT) program is testimony to the ability of the Canadian kidney health community to conceive and execute a vision to meet an identified need.
In 2007, the Horizons 2015 conference was held to further define research directions for the Canadian kidney health community. The objectives for this meeting were:
- To identify and describe key strategic directions to guide kidney research from 2008 - 2015 with a longer term outlook to 2020,
- To describe areas where capacity building is required to support the identified strategic directions in a national kidney research agenda (i.e. developing collaborative approaches, knowledge translation, training programs, technology, platform development, networks).
A total of 109 individuals participated in this conference and six strategic kidney research directions were identified including three relevant to the CAnadian KidNey KNowledge TraNslation and GEneration NeTwork (CANN-NET) proposal: a) mechanisms, prevention, and progression of CKD, b) innovative models to enhance kidney health care and quality of life, and c) CKD as a risk factor for cardiovascular disease. In addition to these research directions, several key initiatives were recommended and prioritized for action in this and subsequent meetings through surveys disseminated to kidney researchers and knowledge users. Two of the initiatives prioritized for action, and relevant to this proposal, included creating a network of researchers across Canada who were conducting kidney research, and creating stronger links between researchers and knowledge users.
Recent guidelines for care and management of patients with CKD were published in 2008, and the CSN clinical practice guidelines committee is active, having produced 8 sets of guidelines, and 2 commentaries over the past 5 years. While an impressive amount of work and effort went into producing these guidelines, there have been no resources available for associated knowledge translation, resulting in a missed opportunity to optimize care for patients with CKD. Moreover, given our urgent need for better data on how to care for patients with kidney disease, it is notable that there is no Canadian Clinical Trials Network for kidney diseases.
A funding opportunity became available at CIHR in the early fall of 2010 (Catalyst Team grant competition) which seemed relevant to this initiative. Although the timelines were short, a meeting of the CSN Scientific Committee was organized shortly after the competition was announced and it was agreed that this could be an opportunity to further the goals set forth in Horizon’s 2015 (specifically establishing a network of clinical researchers and knowledge users in Nephrology). A committee was set up to facilitate an application to this competition working with the CSN and KFOC as partners
We were successful in this competition and have established the CAnadian KidNey KNowledge TraNslation and GEneration NeTwork (CANN-NET), linking Canadian kidney disease guideline producers, knowledge translation specialists and knowledge users to improve knowledge dissemination and care of patients with kidney disease. Given the urgent need for new knowledge, CANN-NET will bring together a national group of experienced Canadian researchers to address knowledge gaps by coordinating and executing multi-centre randomized trials. We have established an organizational structure for CANN-NET and terms of reference for each of the committees. CANN-NET will interact with the CSN Guidelines committee, who will remain an independent committee with its own terms of reference.