CARDIOVASCULAR RISK FACTORS--CHRONIC RENAL INSUFFICIENCY

心血管危险因素——慢性肾功能不全

• 批准号: 6190250
• 负责人: MARK J SARNAK
• 金额: $ 13.04万
• 依托单位: TUFTS MEDICAL CENTER
• 依托单位国家: 美国
• 财政年份: 2000
• 资助国家: 美国
• 起止时间: 2000-09-30 至 2005-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6190250
• 关键词: acute phase protein; blood lipoprotein; cardiovascular disorder; chronic renal failure; clinical research; comorbidity; disease /disorder proneness /risk; glomerular filtration rate; homocysteine; human subject; longitudinal human study; pathologic process; uremias

DESCRIPTION (adapted from the application) Chronic renal disease is a major public health problem in the US. Cardiovascular disease (CVD) is the leading cause of morbidity and mortality. Prevention of CVD in chronic renal disease requires early intervention, during the stage of chronic renal insufficiency (CRI). The general hypothesis for the proposed research program is that the progression of CVD and chronic renal disease share common mechanisms; and that "traditional" and "uremia-related" risk factors, in particular total plasma homocysteine (tHcy), lipoprotein(a) (Lp(a)) and C-reactive protein (CRP), contribute to the progression of both CVD and chronic renal disease. The Principal Investigator (PI) has designed a rigorous training program that will provide him with the necessary-skills, experience and opportunities to develop into an independent investigator in the field of cardiovascular epidemiology in chronic renal disease. He will obtain a Master's of Science in Clinical Care Research, participate in projects utilizing a broad range of study designs for clinical care research, and carry out an original research project from its inception to completion. His mentors have extensive experience in clinical investigation in nephrology, CVD epidemiology and clinical care research methodology. There are currently minimal data available on the incidence of CVD or the risk factors for CVD in CRI. The Modification of Diet in Renal Disease (MDRD) Study was the largest prospective study of patients with CRI, and is an ideal study population for the proposed research. Specific aims are as follows: 1. Measure tHcy, Lp(a), apo(a) isoforms and CRP levels from frozen samples taken at baseline in the MDRD Study and characterize the distribution of levels and their relationship to baseline glomerular filtration rate (GFR) and other factors. 2. Determine whether baseline levels of tHcy, Lp(a), apo(a) isoforms or CRP are predictors of subsequent GFR decline. 3. Resume contact with the MDRD Study cohort, collect data on CVD and renal outcomes, and determine the relationship of traditional and uremia-related risk factors to CVD and renal outcomes. Statistical analysis reveals adequate power to evaluate each aim and a pilot study has documented the feasibility of aim 3. The PI has assembled a team of nephrologists, CVD epidemiologists, and nutrition scientists to assist him in the conduct of the project; enlisted the collaboration of the MDRD Study Data Coordinating Center, and organized internal and external advisory committees to monitor his progress. The proposed L training program and research project will prepare him for a career as an independent investigator.

描述（改编自应用程序） 慢性肾病是美国的一个主要公共卫生问题。 心血管疾病（CVD）是发病率和死亡率的主要原因。 慢性肾病的CVD预防需要早期干预， 慢性肾功能不全（CRI）阶段。一般假设为 拟议的研究计划是，CVD 和慢性肾病的进展 疾病有共同的机制；以及“传统”和“尿毒症相关” 危险因素，特别是血浆总同型半胱氨酸 (tHcy)、脂蛋白(a) (Lp(a)) 和 C 反应蛋白 (CRP)，有助于 CVD 的进展 和慢性肾脏疾病。 首席研究员 (PI) 设计了严格的培训计划 将为他提供必要的技能、经验和机会 发展成为心血管领域的独立研究者 慢性肾脏病的流行病学。他将获得理学硕士学位 临床护理研究，参与利用广泛的项目 临床护理研究的研究设计，并开展原创性研究 项目从开始到完成。他的导师拥有丰富的经验 肾脏病学、CVD流行病学和临床护理的临床研究 研究方法。 目前关于 CVD 发生率或风险的可用数据很少 CRI 中 CVD 的影响因素。肾脏疾病饮食调整 (MDRD) 研究 是 CRI 患者最大规模的前瞻性研究，也是一项理想的研究 拟议研究的人口。具体目标如下： 1. 措施 冷冻样本中的 tHcy、Lp(a)、apo(a) 同工型和 CRP 水平 MDRD 研究中的基线并描述水平的分布和 它们与基线肾小球滤过率（GFR）和其他因素的关系 因素。 2. 确定 tHcy、Lp(a)、apo(a) 同工型的基线水平是否 或 CRP 是随后 GFR 下降的预测因子。 3. 恢复与 MDRD 研究队列，收集 CVD 和肾脏结果数据，并确定 传统危险因素和尿毒症相关危险因素与心血管疾病和肾病的关系 结果。统计分析揭示了评估每个目标的足够能力 一项试点研究已经证明了目标 3 的可行性。PI 已编制了一份 由肾病专家、CVD流行病学家和营养科学家组成的团队提供协助 他参与项目的实施；获得 MDRD 研究的合作 数据协调中心，组织内外部咨询 委员会监督他的进展。拟议的 L 培训计划和 研究项目将使他为独立调查员的职业生涯做好准备。