Mount Sinai Health System Kidney Precision Medicine Project

项目摘要 4000万美国人患有肾脏疾病，预计这一数字将随着肾脏疾病发病率的上升而增加。 CKD合并症，包括糖尿病、肥胖和高血压，叠加在老年患者身上 人口透析治疗和肾移植给终末期肾病患者带来了巨大的经济负担， CKD分期。然而，目前存在有限的工具来预测阿基的进展， CKD和治疗方法的开发受到了令人不安的限制。本报告的总体目标 应用是建立西奈山肾脏精准医学项目（KPMP）招聘网站， 支持更大的联盟的组织询问和表型分析活动。极其需要 利用人肾组织作为鉴定阿基和CKD疾病标志物的研究工具， 阐明有助于肾脏疾病发展和进展的分子途径。我们有 提出了三个具体目标：目标1将建立一个强大的以患者为中心的监督系统， 将不同的患者纳入肾脏活检队列，同时保持最高的安全、质量和 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 KPMP优先事项。这包括利用现有的机构风险分层工具和资源， 并召回因糖尿病、高血压、既往COVID-19感染和 载脂蛋白L1相关疾病。目标3将招募和保留阿基患者以及高风险患者。 通过机器学习算法识别的阿基风险。这些目标由利益相关者委员会监督， 由一个经验丰富的多学科团队执行，将与KPMP财团整合，以完成其 转型目标。

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.