Goals. The Cleveland Chronic Kidney Disease Recruiting Site (CLE-CKD-RS) has been a member of the KPMP since its inception 5 years ago and will continue to recruit a cohort of CKD patients with diabetic kidney disease (DKD) and hypertension-attributable CKD (H-CKD), building on our demonstrated successes. To meet our proposed recruiting targets, we will expand patient screening to the Cleveland Clinic main campus general medicine clinic and CKD clinics in regional facilities, focusing on sites that serve minority communities. The CLE- CKD-RS will strengthen and broaden its relationships with diverse communities to foster trust and ensure the Cleveland KPMP cohort reflects the people most burdened by kidney diseases. Background. Kidney diseases are common, costly and deadly. The Kidney Precision Medicine Project (KPMP) is building a resource, which will have patient-level clinical datasets and molecular phenotypes, to identify hidden, clinically actionable subgroups of people with kidney diseases for discovery of mechanisms, biomarkers and new treatments. The KPMP hypothesizes proposes integration of multidimensional patient data, omic level molecular data and variation in genome sequence will generate tools necessary for needed innovation. CLE-CKD-RS: synergy with and value to KPMP. In the first funding cycle the CLE-CKD-RS research team has successfully executed KPMP protocols to ethically and safely enroll, biopsy and retain a diverse cohort of KPMP participants. In addition, The CLE-CKD-RS has established an engaged Community Advisory Board and used opportunities to educate the medical and patient communities about the KPMP, the burden of kidney diseases and approaches to promote kidney health. Although KPMP activities were first suspended and then slowed by the public health response to the COVID pandemic, the CLE-CKD-RS used telehealth tools to follow our cohort and rapidly restarted activities when permitted. This experience has prepared for future black swan events. Members of the CLE-CKD-RS team serve on KPMP working groups and committees as members and leaders. We participate in two CKD extended clinical phenotyping studies funded by the Opportunity Pool funds and engaged other local investigative groups to join the KPMP by winning Opportunity Pool funding. Building upon these successes, we are proposing the following Milestones: 1. Safely and ethically collect 30-40 research kidney biopsies per year from eligible individuals with H-CKD or DKD with target aggregate enrollment of 180 CKD participants for the 5 year funding period. 2. Retain 90% of enrolled participants in research follow-up visits and activities throughout the funding cycle. 3. Initiate KPMP recruitment at CKD clinics in regional sites that serve the Black and Hispanic communities in years 6 and 7, respectively and maintain recruitment at those sites for the duration of the funding cycle. 4. Broaden in person, expand virtual and live community engagement activities ...