Filling gaps in Kidney disease research: STRIDES Kidney program receives Canadian Institutes of Health Research funding

People living with advanced kidney disease face a difficult challenge: obesity can make their condition worse, yet most weight-loss research and programs leave them out because their medical needs are so complex A clinical trial called STRIDES ( semaglutide therapy, renal health, Individualized diet, daily exercise, engagement through coaching and support) Kidney aims to study this population to address this gap in care.

Led by Dr. Kristin Clemens, clinician scientist and endocrinologist and holder of the Diabetes Canada Chair in Diabetes Management, the STRIDES Kidney program is designed specifically to support weight management in people with advanced chronic kidney disease, including those on dialysis. The project recently received $100,000 in funding from the Canadian Institutes of Health Research (CIHR), support that will help expand the reach and impact of this innovative work.

Closing a critical gap in care

Obesity is a significant risk factor for kidney disease progression and can limit access to kidney transplantation — the preferred, life-saving treatment for kidney failure. Yet patients with advanced kidney disease are frequently excluded from weight-loss clinical trials due to concerns about comorbidities such as diabetes, cardiovascular disease and reduced kidney function, which can increase the risk of medication side effects.

“The gap is that we don’t have strong evidence to guide safe and effective weight management in this population,” says Dr. Louise Moist, clinician scientist and nephrologist, Professor of  Medicine and Epidemiology, Division of Nephrology. “These patients have been left out of many programs and trials, and yet we know obesity is accelerating kidney failure and limiting access to transplant.”

STRIDE was built to address this unmet need. The virtual, personalized intervention that will be studied by Clemens and Moist integrates:  

• Medication support, including newer therapies such as semaglutide
• Kidney-specific nutritional counselling
• Safe, tailored exercise programming
• Behavioural coaching to support long-term lifestyle change

All elements are delivered in a way that accommodates dialysis schedules, physical limitations and the realities of living with advanced disease.

“The goal isn’t just weight loss,” says Dr. Moist. “It’s improving quality of life, increasing physical strength, expanding access to transplantation and ultimately improving both lifespan and health span.”

From innovation to impact

While CIHR funding provides important validation and momentum, the true impact of the grant lies in what it makes possible.

The funding will support research assistants and coordinators, enabling the team to expand the program across Canada and gather high-quality evidence in a population historically under-studied.

“Our team is truly interdisciplinary,” says Dr. Clemens. “We have medical specialists, surgeons, social scientists, certified diabetes educators, kinesiologists and patient partners. Our work bridges academia and community, and it’s been shaped by the lived experiences of patients.”

With approximately 15 members, the team has spent five years building the foundation needed to launch STRIDES. The project also reflects a strong commitment to patient-oriented research. The grant was identified as a priority by CIHR’s Strategy for Patient-Oriented Research panel, which funds  projects with meaningful, real-world impact.

“That recognition is very meaningful to us,” says Dr. Clemens. “This work began with patient-oriented research years ago, and to see it still resonate as important to patients and advocates is incredibly rewarding.”

Redefining routine kidney care

STRIDES could fundamentally change how obesity is addressed in kidney care.

In five to ten years, weight management could become embedded in routine kidney treatment — just like managing blood pressure or blood sugar. Instead of being told they are “too high risk” for transplant, patients could access proven, evidence-based programs tailored to their needs.

The virtual design may also help reduce inequities by reaching patients who face barriers to in-person care, including those in rural or remote communities and populations historically underserved by traditional programs.

“This is about shifting from crisis management to prevention and empowerment,” says Dr. Moist. “Healthy living becomes part of what we do”

By generating high quality evidence and demonstrating feasibility at scale, the STRIDES Kidney project has the potential to inform clinical guidelines and health policy beyond a single clinic or institution.