Identifying Healthy and High-Risk Weight Loss Phenotypes to Optimize Obesity Management in End Stage Kidney Disease
识别健康和高风险的减肥表型以优化终末期肾病的肥胖管理
基本信息
- 批准号:10179372
- 负责人:
- 金额:$ 29.19万
- 依托单位:
- 依托单位国家:美国
- 项目类别:
- 财政年份:2020
- 资助国家:美国
- 起止时间:2020-06-01 至 2025-05-31
- 项目状态:未结题
- 来源:
- 关键词:Benefits and RisksBiological MarkersBlood PressureBody CompositionBody WeightBody Weight decreasedBody mass indexCaringCessation of lifeCharacteristicsChronicChronic DiseaseClinicalConfidence IntervalsConsensusDataData SetDialysis patientsDialysis procedureDietitianEnd stage renal failureEnrollmentEnsureFoundationsGoalsGuidelinesHealthHealth StatusHemodialysisHospitalizationIndividualInflammationInflammatoryIntakeInterviewJointsKidneyKidney DiseasesKidney TransplantationKilogramKnowledgeLinkLongitudinal StudiesMachine LearningMalnutritionMeasuresMedicalModelingMuscle functionMuscular AtrophyNephrologyNon obeseNutritionalObesityOutcomePatient-Centered CarePatientsPhenotypePhysiciansPhysiologicalPopulationProcessProspective cohort studyProviderQuality of lifeReportingResearchResearch ProposalsRiskRisk FactorsScienceServicesStructureTechniquesTransplant RecipientsUnited StatesVulnerable PopulationsWeightadverse outcomeclinical careclinical predictorscohortdata registryexperiencehazardhealth related quality of lifehealthy weighthemodynamicshigh riskimprovedimproved mobilityinflammatory markermachine learning algorithmmetermorphogensmortalitymortality riskmuscle formmuscle strengthnovelnutritionobese patientsobese personobesity managementpatient orientedpatient populationpredictive modelingpredictive toolspreventprospectivereduced muscle strengthsarcopeniasleep qualitystakeholder perspectivestoolweight loss intervention
项目摘要
Project Summary/Abstract
In 2016, 47,000 individuals who initiated dialysis in the United States (~42% of all incident dialysis
patients that year) had obesity, with a body mass index (BMI) of ≥ 30 kilograms per meters squared. Across
the BMI spectrum, individuals with kidney disease commonly lose weight after initiating dialysis treatment.
However, whereas body weight typically stabilizes after the first several months of dialysis among patients
without obesity, those with obesity often continue to lose weight. Both people with and without obesity who are
on dialysis may lose weight due to muscle wasting and malnutrition, and recent studies have identified weight
loss as a risk factor for death among people on dialysis, independent of BMI. Yet, some of the weight loss
observed among obese dialysis patients may also reflect deliberate attempts to improve health, mobility, or
access to kidney transplantation. Currently, there are no guidelines to help clinicians to differentiate between
healthy and high-risk weight loss among people with obesity on dialysis. Further, typical obesity management
paradigms are not easily transferrable to obese people with end-stage kidney disease, given factors such as
chronic malnutrition, inflammation, and sarcopenia in this population that may modify the risks and benefits of
different weight loss strategies. Therefore, the overarching goal of this five-year research proposal is to define
healthy and high-risk weight loss phenotypes among people with obesity who are on dialysis, and to provide
clinically feasible tools to improve obesity management in the setting of end-stage kidney disease. We will
accomplish this goal by conducting three distinct but interrelated studies. In the first study, we will qualitatively
determine patient-prioritized endpoints of weight loss, in addition to patient, physician and other stakeholder
perspectives on the key factors that differentiate healthy from high-risk weight loss on dialysis. In the second
study, we will leverage a national dataset of 23,000 obese dialysis patients and apply constructs of high and
low physiologic reserve to derive healthy and high-risk weight loss phenotypes. We will then develop a weight-
loss risk calculator tool that predicts the risks of hospitalization and death that are associated with each weight
loss phenotype, using dynamic predictive joint models and machine learning techniques. In the third study, we
will enroll 250 obese dialysis patients in a prospective, longitudinal study across five regions in the United
States to evaluate the association between nutritional, inflammatory, and hemodynamic biomarkers and
measures of health trajectory that are not typically captured in registry data, such as sarcopenia, dynapenia,
body composition, and patient-prioritized endpoints such as quality of life. In accomplishing its aims, this
research will provide urgently needed knowledge and tools that will improve the medical management of tens
of thousands of people with end-stage kidney disease and obesity, ensuring that clinicians will be better able to
incorporate patient-prioritized outcomes into assessments of weight loss interventions, and recognize and
mitigate the effects of high-risk weight loss.
项目总结/文摘
项目成果
期刊论文数量(0)
专著数量(0)
科研奖励数量(0)
会议论文数量(0)
专利数量(0)
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Meera Nair Harhay其他文献
The Affordable Care Act and Trends in Insurance Coverage and Disease Awareness Among Non-elderly Individuals with Kidney Disease
- DOI:
10.1007/s11606-018-4713-2 - 发表时间:
2018-10-26 - 期刊:
- 影响因子:4.200
- 作者:
Meera Nair Harhay;Ryan M. McKenna - 通讯作者:
Ryan M. McKenna
Meera Nair Harhay的其他文献
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{{ truncateString('Meera Nair Harhay', 18)}}的其他基金
Identifying Healthy and High-Risk Weight Loss Phenotypes to Optimize Obesity Management in End Stage Kidney Disease
识别健康和高风险的减肥表型以优化终末期肾病的肥胖管理
- 批准号:
10405626 - 财政年份:2020
- 资助金额:
$ 29.19万 - 项目类别:
Identifying Healthy and High-Risk Weight Loss Phenotypes to Optimize Obesity Management in End Stage Kidney Disease
识别健康和高风险的减肥表型以优化终末期肾病的肥胖管理
- 批准号:
10649563 - 财政年份:2020
- 资助金额:
$ 29.19万 - 项目类别:
Patterns and Implications of Functional Decline Among Kidney Transplant Candidates
肾移植候选者功能衰退的模式和影响
- 批准号:
9752537 - 财政年份:2015
- 资助金额:
$ 29.19万 - 项目类别:
Patterns and Implications of Functional Decline Among Kidney Transplant Candidates
肾移植候选者功能衰退的模式和影响
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8867668 - 财政年份:2015
- 资助金额:
$ 29.19万 - 项目类别:
Rehospitalization after Renal Transplant: Patterns, Predictors, & Implications
肾移植后再住院:模式、预测因素、
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8526725 - 财政年份:2013
- 资助金额:
$ 29.19万 - 项目类别:
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