Mount Sinai Health System Kidney Precision Medicine Project

项目概要 四千万美国人患有肾病，预计这一数字会随着肾病发病率的上升而增加 老年患者患有 CKD 合并症，包括糖尿病、肥胖和高血压 人口。透析治疗和肾移植给最终患者带来了巨大的经济负担。 CKD 阶段。然而，目前预测 AKI 进展和进展的工具有限。 令人失望的是，CKD 及其疗法的开发受到了限制。本次活动的总体目标 申请旨在建立西奈山肾脏精准医学项目（KPMP）招募站点 支持更大联盟的组织询问和表型分析活动。有一个巨大的需求 利用人体肾脏组织作为识别 AKI 和 CKD 疾病标志物的研究工具 阐明有助于肾脏疾病发生和进展的分子途径。我们有 提出了三个具体目标： 目标 1 将建立一个以患者为中心的强大监督体系，以招募 将不同的患者纳入肾活检队列，同时保持最高的安全性、质量和标准 道德研究行为。在目标 2 中，我们将招募并保留一系列 CKD 患者，以应对 毕马威会计师事务所的优先事项。这包括利用现有的机构风险分层工具和资源来识别 并回顾因糖尿病、高血压、既往感染过 COVID-19 且有 CKD 进展风险的患者 载脂蛋白L1相关疾病。目标 3 将招募并留住 AKI 患者以及高危患者 机器学习算法识别的 AKI 风险。这些目标由利益相关者委员会监督， 由经验丰富的多学科团队执行，将与 KPMP 财团整合以完成其 变革性目标。

Project Summary Forty million Americans live with kidney disease and this number is projected to increase with rising rates of CKD comorbid conditions, including diabetes, obesity, and hypertension, superimposed on an aging patient population. A tremendous financial burden is imparted by dialysis therapy and kidney transplantation for end- stage CKD. At present, however, there are limited tools in existence to predict the progression of AKI and CKD, and development of therapies has been disappointingly restricted. The overall objective of this application is to establish the Mount Sinai Kidney Precision Medicine Project (KPMP) recruitment site in support of the larger consortium’s tissue interrogation and phenotyping activities. There is a tremendous need to utilize human kidney tissue as a research tool for the identification of AKI and CKD disease markers to elucidate molecular pathways that contribute to kidney disease development and progression. We have proposed three Specific Aims: Aim 1 will establish a robust system of patient centered oversight to recruit diverse patients into a kidney biopsy cohort while maintaining the highest standards of safety, quality and ethical research conduct. In Aim 2 we will recruit and retain a spectrum of patients with CKD in response to KPMP priorities. This includes leveraging existing institutional risk stratification tools and resources to identify and recall patients at risk for CKD progression due to diabetes, hypertension, prior COVID-19 infection and apolipoprotein L1 associated disease. Aim 3 will recruit and retain patients with AKI as well as those at high risk for AKI identified by a machine learning algorithm. These Aims overseen by a stakeholder board and executed by an experienced multidisciplinary team, will integrate with the KPMP consortium to accomplish its transformative aims.