Mount Sinai Health System Kidney Precision Medicine Project

项目摘要 4000万美国人患有肾脏疾病，这一数字预计将随着肾病发病率的上升而增加 慢性肾脏病合并疾病，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患者带来了巨大的经济负担。 CKD分期。然而，目前存在的预测AKI和AKI进展的工具有限 CKD，治疗方法的发展受到了令人失望的限制。这样做的总体目标是 申请建立西奈山肾脏精准医学项目(KPMP)招聘现场 支持较大财团的组织讯问和表型鉴定活动。有一个巨大的需求 利用人肾组织作为鉴定AKI和CKD疾病标志物的研究工具 阐明肾脏疾病发生和发展的分子途径。我们有 提出三个具体目标：目标1将建立健全的以患者为中心的监督制度，以招募 将不同的患者纳入肾活检队列，同时保持最高标准的安全性、质量和 道德研究行为。在目标2中，我们将招募和保留一批慢性肾脏病患者，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来确定 并召回因糖尿病、高血压、既往感染新冠肺炎和 载脂蛋白L1相关疾病。AIM 3将招募和留住AKI患者以及高级别患者 通过机器学习算法识别的AKI风险。这些目标由利益相关者董事会监督， 由经验丰富的多学科团队执行，将与KPMP财团整合，以实现其 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.