STATEMENT OF THE NEPHCURE FOUNDATION (NCF) ON

FISCAL YEAR 2007 APPROPRIATIONS FOR THE

NATIONAL INSTITUTES OF HEALTH

PRESENTED BEFORE THE

SENATE APPROPRIATIONS SUBCOMMITTEE ON LABOR, HEALTH AND HUMAN SERVICES, EDUCATION, AND RELATED AGENCIES

BY DR. LAWRENCE HOLZMAN, M.D.

CHAIRMAN, SCIENTIFIC ADVISORY BOARD OF THE NEPHCURE FOUNDATION

MAY 19, 2006

"Mr. Chairman, and members of the Subcommittee, thank you for giving me this opportunity to come before you today. I am Dr. Lawrence Holzman, Associate Professor of Internal Medicine and Director of the NIH-sponsored Nephrology Training Program at the University of Michigan Medical School. I also serve as Chairman of the Scientific Advisory Board of the NephCure Foundation (NCF), a non-profit organization dedicated to fighting idiopathic nephrotic syndrome and focal segmental glomerulosclerosis (FSGS).

Fifteen million Americans have significantly impaired kidney function and are at risk of losing their kidney function entirely. Another 400,000 have already lost their kidney function. Despite NIH-sponsored advances in dialysis and kidney transplantation, kidney failure—due to common diseases such as diabetic kidney disease or hypertension, or due to relatively rare diseases such as focal segmental glomerulosclerosis—remains a devastating diagnosis. Kidney failure carries a shortened survival similar to that of many cancers and assures a lifetime of severe medical complications. The American people spend nearly $20 billion per year to provide medical care for these individuals alone. Undeniably, there remains a critical need to prevent patients from losing kidney function.

Recognizing this need, NIH-sponsored investigators have made great strides in the basic science and clinical science of kidney disease, progress that has begun to slow the incidence of kidney failure. For example, during the past decade, a revolution in our understanding of the biology of the kidney filter sparked by initial successes in molecular genetics has allowed the identification of several inherited diseases of the kidney filter and promises to provide tools that will much better guide diagnosis and treatment of the patients who are likely to lose their kidneys. Dramatic advances in our understanding of the biology of cystic diseases of the kidney such as polycystic kidney disease has led to promising clinical trials of medications that might slow or prevent these diseases. For those patients that have already lost their native kidneys to disease, NIH-sponsored research has improved our understanding of the immune system, providing hope for kidney transplant patients who suffer the dangerous side effects of present day anti-rejection medications and who suffer from the knowledge that the average kidney transplant lasts only 11 years. Moreover, dialysis patients have improved quality of life because NIH sponsored clinical research has taught nephrologists how to better care for their patients.

Cutting the NIH-budget for kidney disease research, or even failing to keep up with the inflation in costs for doing this research, immediately threatens the research momentum that was attained by doubling the NIH budget. As an independent investigator, and as member of an NIH peer review committee that evaluates independent-investigator initiated scientific proposals, I can assure you that the affects of a restricted NIH budget are already being felt in a real but difficult to quantify fashion. Threatened by a “pay line” at which only 12-14% of grant applications are funded (rather than 24% just three years ago), investigators have become reluctant to take risks that must be taken in their research that would dramatically advance a field. Delays in funding outstanding proposals (because they must be recycled through the application process several times before they are funded) retard progress and result in the loss of talented and uniquely trained research personnel that cannot be readily replaced. Finally, despite NIH set asides designed to protect junior investigators, our next generation of talented young people observe the anxiety created by funding uncertainty, make rationale economic decisions, and turn away from a career in biomedical science, leaving the future of this science in jeopardy.

NIH sponsored biomedical research is an American treasure that reaps multifold benefits; it is a treasure that must be nurtured and protected. Therefore, we ask you to provide an increase of 5% in Fiscal Year 2007 for the National Institute of Diabetes, Digestive, and Kidney Diseases (NIDDK), and the NIH overall.

Thank you. "