Get ready for the healing power of data and algorithms. Fresenius Medical Care is on the verge of tapping a vast new resource that will produce novel insights and, in the process, change renal care as we know it. Connected care will make it possible to tailor therapies to individual patients, help academics decode the warning signs and underlying causes of renal disease, and empower pharmaceutical companies to speed up the development of new, life-saving drugs.

“We are at the beginning of a fundamental improvement in health and kidney care. Digital technologies bring rapid and major changes and hold great promise for patients, physicians and researchers,” says Kirill Koulechov, Senior Vice President for Global Research and Development in the area of machines and digital solutions at Fresenius Medical Care.

“Consumers have become used to simple, intuitive tools and software that make their lives easier, and the same is happening in health care as digital solutions become an integral part of it.” The overarching goal, according to Koulechov, is to better connect people at the point of care and in home care scenarios for improved outcomes and lower costs.

Fresenius Medical Care is the world's leading provider of products and services for individuals with renal diseases of which around 3.8 million patients worldwide regularly undergo dialysis treatment.

Fresenius Medical Care is also the leading provider of dialysis products such as dialysis machines or dialyzers. Along with its core business, the Renal Care Continuum, the company focuses on expanding in complementary areas and in the field of critical care.

The vision that Fresenius Medical Care has laid out in its Strategy 2025 is to unlock the potential of digitalization by combining the power of patient data with its technological leadership in dialysis equipment and care.

The Company has built a large repository of clinical data on advanced kidney disease, encompassing information from more than two million patients, over half a billion hemodialysis treatments and almost two billion laboratory tests.

This abundant source of information is constantly expanding as devices collect more and more diagnostic, environmental and operational data to monitor each patient’s condition and facilitate care.

“We are sitting on a treasure trove, because we are able to connect the dots. It’s not just the sheer number but also the quality of the data,” explains Koulechov. “Since many patients stay with us for years, we can see the changes in one person over time and compare deviations with historical values. We can incorporate this information into important medical decisions for the benefit of patients.” He points to modality management as one example, where a predictive model can forecast when a home dialysis patient is at risk of dropping out and make proactive recommendations to ensure continued access to care.

Digital technologies bring rapid and major changes and hold great promise for patients, physicians, and researchers.

Engineers on his team are building advanced tools that mine and refine this information with the help of artificial intelligence. These insights are incorporated into services, such as a digital hub for care teams, apps for physicians to customize treatment or companion apps for use on patients’ smartphones. “It opens up new opportunities for early detection and support, particularly in home care,” says Koulechov.

In addition to using the database as a tool for better patient care, the Company will also establish the largest genomic registry with a focus on kidney disease. Frenova Renal Research, Fresenius Medical Care’s contract clinical research arm which is part of the Global Medical Office, has started signing up patients, initially in the U.S., who want to provide their genetic data.

“Nephrology has been underrepresented in clinical research compared to fields like oncology or cardiology. Now, we want to bring personalized medicine to renal care,” says Kurt Mussina, President of Frenova, pointing to the recently launched “My Reason” campaign.

We want to bring personalized medicine to renal care.

Mussina adds, “Patients who donate a blood or saliva sample for DNA sequencing are doing their part to advance the science of renal therapies. Their reason to participate is to help others down the road, perhaps even their own family members, as kidney disease is sometimes hereditary. By doing so, they are making a gift to future generations.”

Augmenting the genomic registry with clinical data will make it even more effective in improving care. Mussina sees pairing genetic data with the mountain of clinical data as the secret to catalyzing research into novel drug targets and therapies. As a result, the registry that Frenova plans to license to academics as well as pharmaceutical and biotech companies, will become a living engine.

Researchers will be able to examine the de-identified data to look for biomarkers that can tell them how susceptible individuals are to kidney disease and how they might respond to interventions. The goal is to reduce the cost and risk associated with clinical trials, bringing new therapies to market faster. Additionally, the data can be used to run virtual clinical trials in which patients are represented by mathematical models. The findings from these can help to improve the algorithms used in everyday clinical care.

Leaving behind the disruptions caused by the pandemic, Frenova hopes to sign up enough patients over the coming year and possibly see the first insights published within two years. The goal is to combine the genetic data of 100,000 patients or more. “We have taken great care to put the right privacy and data security measures in place to safeguard the genetic data as well as all other data we collect from patients,” says Mussina.

While those academic endeavors will take some time to bear fruit, both Koulechov and Mussina see a more immediate payoff from digitalization over the entire renal care continuum. Connected kidney care means getting patients involved much earlier and improving their quality of life with the help of digital care models that cover all stages of treatment, from education to transplantation. Capturing key metrics such as heart rhythms, fluid volumes and stress on the muscles and blood vessels that supply the kidneys can be included in a feedback loop that automatically adjusts treatment for the right patient at the right time.

Sometimes, meaningful digital innovation comes in even smaller doses. “Patients don’t want to face their journey alone. Depression is an all-too-common problem,” Koulechov explains. “It can help to have an app with underlying algorithms that ask you how you feel and rate your treatment, or to have friends and family do it if you aren’t digitally savvy.” It is another aspect of connected care worth exploring and can be an important part of assessing quality of life.

There are many reasons to donate health data to science. The “My Reason” campaign appeals to the most powerful of all: altruism, or doing something for future generations.

Kidney patients who sign up for the new genetic registry by Frenova Renal Research will be safely sharing their DNA sequence so researchers can better understand kidney disease and develop innovative therapies.

“This genomic registry can grow into a comprehensive tool for renal research and provide a new business line by licensing access to the research community,” says Frenova president Mussina. “It brings together patients, their families, patient advocacy groups, physicians and researchers for a common cause: to introduce personalized medicine to the field of nephrology.”

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