kidneys, and while transplants from living donors offer many advantages (eg, superior graft and patient survival, shorter wait times, lower health care costs), Canada’s rate of living kidney donation has stagnated since 2006 and is 35% lower than several Western nations. Informed by our patient partners, we aim to improve the quality and efficiency of the donor candidate evaluation process throughout Canada. We will measure current processes, develop national consensus on the goals of an efficient evaluation process, and develop and test solutions to realize these goals. A second priority is to evaluate a multicomponent strategy launched in Ontario to support patients to improve their access to kidney transplantation with a focus on living kidney donation. This strategy includes administrative support to programs and providers, a patient-centered approach to transplant education and choice, and peer mentorship. The lessons learned will inform future initiatives in other provinces. If this multicomponent strategy is effective, it will result in improved access to kidney transplantation, better patient outcomes, and significant health care system savings. Moreover, if we see an increase in kidney transplant referrals in the multicomponent intervention, this will provide evidence to support the need for government spending on strategies to improve access to kidney transplantation. Note. Can-SOLVE CKD = Canadians Seeking Solutions and Innovations to Overcome Chronic Kidney Disease; CKD = chronic kidney disease. Levin et al 7 Table 3. Network Core Infrastructures. Network core infrastructures Description Linked Canadian biorepositories in glomerulonephritis, diabetes and polycystic kidney disease The existing core infrastructure facilities described below will expand glomerulonephritis, diabetes, and polycystic kidney disease initiatives and enable the proposed Can-SOLVE CKD projects. All initiatives will utilize a secure web-based clinical research tool to access de-identified patient data. Access to patient-specific tissue archives will be enabled by secure linkage to the web platform. 1. The Glomerulonephritis and Pathology Registry: The Ontario Glomerulonephritis (GN) Registry will be expanded to collect information on GN patients across Canada. Both include baseline and longitudinal data on patient demographics, histology, medications, and laboratory results. 2. The AMGEN Canada Inc Renal Molecular Diagnostic Laboratory dedicated to GN and diabetic nephropathy currently supports investigators in Ontario, but will be expanded nationally to facilitate analysis of gene expression and proteins in biopsies (kidney, skin, lung) urine, and blood.20-24 3. The Polycystic Kidney Disease Research Registry is a standardized platform adaptable to housing the proposed multidisciplinary PKD research program including a clinical database with mutation and total kidney volume data linked to a biobank of ~2000 DNA and ~500 urine samples.25-28 4. The international AdDIT29 research team is based at Toronto’s Hospital for Sick Children and includes research coordinators, technicians, and cardiac sonographers, with a proven track record of productivity.23,30-33 5. The Improving Renal Complications in Adolescents With Diabetes Through Research Study (iCARE) is a national network based at the Children’s Hospital Research Institute of Manitoba in Winnipeg with expertise in care of youth with type 2 diabetes. National nephrology clinical trials network Linking investigators, research personnel, patients, and policy makers is critical for successful randomized controlled trials that can change practice and improve patient care. Over the past year, the network team established the CNTN (www.CNTN.ca),34 a key Can-SOLVE CKD infrastructure that will address research questions relevant to all stages of CKD. This will increase Canadian capacity to design and perform robust RCTs. The network will further extend CNTN capacity to answer those questions most important to patients and knowledge users. National registry of patients interested in participating in clinical trials Insufficient enrollment is a major barrier to successful RCT completion, especially in CKD, where trials are relatively infrequent and unfamiliar to patients. A patient network will be created for trials participation and treatment evaluation. We will create a registry of over 3000 consenting patients with advanced CKD who will be notified of trials for which they may be eligible. This will include planning and executing trials for participants with specific symptoms, who will be randomly selected to receive a promising therapy, with evaluation using the optimal patient-reported outcome measures.35,36 Laboratory for development of novel KT tools Existing KT resources (both human capital and experience) will be expanded to support the development and implementation of electronic tools (including clinical decision support systems, and patient decision aids), which will be comprehensively evaluated in multiple projects. KRESCENT multidisciplinary training and mentoring program The innovative and highly successful interdisciplinary national KRESCENT training program will add training streams for patients and policy makers. The goal of KRESCENT is to train an increased number of highly skilled scientists, with a focus on the prevention of end-