Applying the Public Health Exposome Model to Improve Kidney Disease Outcomes for Patients and Populations.

The genome is insufficient for understanding chronic health conditions, such as kidney disease. Only a small portion of chronic disease incidence can be attributed to genetic causes, and the field of exposomics provides an opportunity to explore the impact of environmental exposures on kidney disease. The environment plays a significant role in lifestyle choices and the stressors or exposures the body encounters throughout life. Exposures influence genetic expression, thereby impacting health and wellbeing of individuals exposed. Stressors or exposures are common experiences that may lend to understanding health disparities in vulnerable populations because environments are shared among families, neighborhoods, and communities. The Public Health Exposome Model examines the interplay among individuals, their personal attributes, environments, stressors/exposures, moderating factors, and individual and population health outcomes. Applying this model to kidney disease, nephrology nurses can lead community-based efforts to uncover ways to improve health outcomes for individuals with kidney disease and reduce incidence risk for future generations, thereby improving population health outcomes.