Literature-related discovery and innovation: Chronic kidney disease

Different approaches for preventing, reducing, halting, and reversing chronic kidney disease (CKD) have been described in the medical literature. However, all related factors have not been identified together. To overcome these limitations, we used an LRDI-based methodology (potentially applicable to any disease) based on the following holistic principle: a necessary, but not sufficient, condition for restorative treatment effectiveness is that potential causes must be removed initially or in parallel with treatment. Literature-Related Discovery and Innovation (LRDI) is a text mining approach that integrates discovery generation from disparate literatures with the wealth of knowledge contained in prior scientific publications. To support the central requirement of the holistic principle above, LRDI seeks to identify foundational causes that, if eliminated, could potentially reverse chronic and infectious diseases.The LRDI findings would be implemented in three steps by: 1) identifying major symptoms of CKD, 2) identifying and removing foundational causes that drive the symptoms identified, then 3) identifying treatment(s) to reduce, halt, or reverse the progression of CKD and eliminate the remaining symptoms and damage caused by CKD (if not irreversible). We presumed that identifying and eliminating all of the foundational causes as comprehensively, thoroughly, and rapidly as possible may potentially achieve the desired medical goals and obviate the need for any pharmacologic treatments in selected patients. If treatments are required, eliminating the wide spectrum of potential causes identified in this study should enhance their effectiveness.There were two major types of advances made in this study: information technology and medical. The major information technology advance was development of a query to identify the full-spectrum of foundational causes for CKD, and substantially upgrading a query used previously to identify the full spectrum of treatments. The major medical advance was identification of over 900 potential CKD direct and indirect foundational causes that encompass discovery and innovation, along with over 900 CKD direct and indirect treatments that encompass discovery and innovation. The foundational causes were comprised of environmental and occupational exposures, biotoxins, iatrogenic, and lifestyle factors. The myriad treatments ranged from foods, food extracts, drugs, biological, biophysical, and lifestyle changes. A limitation of the LRDI method is that the magnitude of these associations cannot be determined. Nonetheless, after prioritizing potentially relevant factors, eliminating as many upstream or foundational causes as possible may provide benefits to patients with CKD beyond the current emphasis on downstream pharmacologic approaches.

Duke Scholars

Author Uptal Dinesh Patel Medicine, Nephrology