Grant: Operating Grant

Blood and urine tests are the front line in screening and diagnosis of disease. For example they are used to help diagnose diabetes and to monitor its treatment (blood glucose testing). They are also used to identify people most likely to develop heart disease (cholesterol testing). The main purpose of this proposal is to develop new tests that would benefit two large groups of patients through more rapid and accurate diagnosis. Such tests could also save the Canadian health care system an enormous amount of money. The first test would provide rapid diagnosis of the 800,000 Canadians who visit hospitals every year with chest pain. There is no fast way to rule out heart attacks in the 90% of patients whose EKG's are inconclusive. A large fraction of them (typically 70%) are admitted to the hospital for tests that can take several hours or days to confirm a heart attack. More than half will ultimately be discharged with heart attack ruled out. The new test would quickly rule out heart attacks in these individuals and allow their rapid discharge from hospital. Cost savings would be $2,000 per patient, or $600,000,000 annually in Canada alone. Equally important would be faster treatment for those who require it, sparing the loss of heart function - or worse - associated with treatment delays or misdiagnosis. The second test would benefit patients with chronic kidney disease by forecasting the rate at which their disease would progress if untreated. The test result would be used to trigger aggressive preventive therapy for those patients who would otherwise deteriorate rapidly, and spare such interventions for those (the majority) who remain clinically stable. Discovery of such a test has been declared by the U.S. National Kidney Foundation to be the most urgent priority in chronic kidney disease research. The potential impact can be appreciated by estimates that up to 10% of the general population suffer from chronic kidney disease.