Despite advances in adult therapies for glomerular diseases, pediatric clinical trials remain scarce, limiting tailored treatment options for children and young adults. The BRIDGE program at Riley Children’s Health, a novel initiative integrating clinic visits and research, embeds longitudinal patient care with biorepository and registry development. Combining patient visits with research activities, the approach improves access to expert care, facilitates crucial biomarker discovery and enhances recruitment for pediatric clinical trials.
Launched in April 2025, BRIDGE (Biorepository, Registry, Integrated Clinic, Biomarker Discovery and Glomerular Disease Exploration) is led by Myda Khalid, MD, a pediatric nephrologist at Riley Children’s and a nationally recognized leader in pediatric glomerular disease treatment and research. Serving as co-leader, Andrew Schwaderer, MD, is a Riley nephrologist and basic science researcher and program leader at the Herman B Wells Center for Pediatric Research at Indiana University School of Medicine and Riley Children’s.
Dr. Khalid and Dr. Schwaderer believe that by integrating specialized clinical care and basic science research, BRIDGE is a forerunner and model of where academic medical research is headed in the next decade. The two experts answered questions about how the program aims to improve diagnosis, management, and therapeutic development for children with glomerular diseases.
Q: What was the impetus for launching BRIDGE?
Dr. Schwaderer: We lack pediatric-specific biomarkers, and nephrology generally lags in biomarker development. For the pediatric biomarkers that do exist and have been published, very few are brought full circle to clinical practice. As a local integrated study clinic, BRIDGE provides the infrastructure to go from sample collection to discovery then back to testing, and eventually implementation. We need to implement biomarkers in kids to provide better, less invasive care, and we think BRIDGE will allow us to do that faster and more efficiently.
Dr. Khalid: Acceleration of therapeutic development was a key factor. The pace of discovery in pediatric glomerular disease is unacceptable, motivating us to develop innovative ways to gain insights that drive new therapies. While drug discovery takes place in longitudinal cohorts, many of the larger studies have strict inclusion and time-intensive criteria that dissuade many patients from participating. Capitalizing on Riley’s large patient population and with virtually no barriers to patient participation, BRIDGE allows us to collect real-world longitudinal data that is representative of patients in our communities suffering from this condition. At Riley, we have both the resources and incredible, trusting patients who are willing to help; it just made sense to build a program that can help move the needle more rapidly.
Q: What are the benefits of a local study clinic like BRIDGE that integrates clinical care and research?
Dr. Khalid: There is built-in efficiency in combining the data and sample collection with the clinic visit. The patients are coming to see us anyway; the only change is that instead of coming to our regular nephrology clinic, they come to the study clinic. We’ve removed a barrier to participation and significantly decreased the burden on our patients to participate. Of the 20 patients we’ve recruited to join BRIDGE, only two have declined, and those two enrolled in a clinical trial.
Dr. Schwaderer: There are components of BRIDGE that are being done in other centers, but our process of bringing research and an active biomarker program to the point of care and concentrating the activity in one location is unique. With the lab right down the hall from the clinic, everything is done within a very coordinated, standardized process. From a sample integrity standpoint, we have an exceptional audit trail that makes the science more robust.
Q: Why is Riley Children’s particularly well equipped to execute a study clinic like BRIDGE?
Dr. Schwaderer: In addition to having an institutional commitment and seed funds from the Department of Pediatrics, we’ve been able to take advantage of the significant research infrastructure that exists at Riley. These resources include the Children’s Clinical Research Center (CCRC) and its lab on site, and the Wells Center, where my group performs much of the biomarker work. The research service cores and resources provided by the Indiana Clinical and Translational Sciences Institute are excellent and allow us to conduct leading-edge studies on some of the samples. In addition, we have an exceptionally strong pathology department at Riley with nationally recognized experts who help us sort out and understand the diagnosis.
Dr. Khalid: A program like this is very dependent on physician expertise. We have a deep understanding of where research in this field is going and the areas in need of improvement. Our team cares about the patients, and our priority is to change outcomes for the better for these children and young adults. We have a shared vision and boundless energy that propels our work. I also can’t say enough about the contributions of our patients and families. Their participation in the study clinic makes the research possible, and we would not be able to do this work without them.
Q: What is BRIDGE’s current research focus and how is the effort progressing?
Dr. Schwaderer: During these first few months, we’ve been taking a more detailed look at identifying more accurate biomarkers to diagnose glomerular disease and determine whether treatments are working. Currently, a blood test for kidney function and a urine test for protein levels are the primary biomarkers that have remained unchanged for decades. The urine protein can occur from active disease, which needs one kind of treatment, or from scarring in the kidney, which needs a different treatment. We need a way to tell which is which. We are working on several manuscripts and expect to have exciting results over the coming year.
Dr. Khalid: We’re beyond excited about BRIDGE and its potential. So many good things have come out of it, but one of the things I wasn’t expecting is the overwhelming response and engagement of our patients. It’s apparent how important it is to patients with glomerular disease to know that research is underway, and it’s empowering for them to play an active role in our progress.
Learn more about Riley Children’s Nephrology achievements in the annual report.