A Prospective Study of Young Adults with ESRD

患有 ESRD 的年轻人的前瞻性研究

• 批准号: 6524069
• 负责人: RULAN S PAREKH
• 金额: $ 14.2万
• 依托单位: JOHNS HOPKINS UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2001
• 资助国家: 美国
• 起止时间: 2001-09-30 至 2005-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6524069
• 关键词: atherosclerosis; calcification; cardiovascular disorder epidemiology; carotid artery; chronic renal failure; computed axial tomography; coronary artery; coronary disorder; dialysis; disease /disorder proneness /risk; electrocardiography; human morbidity; human mortality; human subject; hypertension; insulin dependent diabetes mellitus; kidney transplantation; longitudinal human study; outcomes research; pathologic process; patient oriented research; prognosis; ultrasonography; ultrasound blood flow measurement; young adult human (21-34)

DESCRIPTION (adapted from the application) The candidate, Rulan Parekh, is on the faculty at Johns Hopkins University, in the Division of Nephrology, Departments of Pediatrics and Medicine. She is trained in both adult and pediatric nephrology and has obtained a Masters of Science in Biostatistics and Clinical Research Design at the University of Michigan. Her goal is to become a clinician-scientist focused on cardiovascular disease and ESRD using the tools of epidemiology and biostatistics. To realize this goal, she has designed a program of course work that supplements previous training, and which includes structured mentoring by senior investigators, and the conduct of supervised, innovative research. Advanced Ph.D. level courses in genetic and cardiovascular epidemiology, among other topics will be taken. The structured mentoring will take place within the Welch Center for Prevention, Epidemiology, and Clinical Research. This center bridges the Schools of Public Health and Medicine and is a very rich research and mentoring environment. The research training vehicle proposed includes: 1) describing patterns of ASCVD risk factors in young adults with ESRD from the United States Renal Data Systems (USRDS) database; 2) an analyses of the incidence of ASCVD in young adults and its associated risk factors in the USRDS during five-years of follow-up; 3) a case-control study to compare the prevalence of sub-clinical ASCVD in 125 young adults ages 18-35 with ESRD treated in the Johns Hopkins/Gambro Outpatient Dialysis Units compared to 125 age matched type I DM controls treated in the Johns Hopkins Outpatient Center. The prevalence of sub-clinical atherosclerotic cardiovascular disease will be measured by two innovative non-invasive approaches of Doppler sonography of the carotid vessels to assess carotid intimal medial wall thickness, and ECG-triggered helical CT of the coronary vessels to assess coronary calcification. The prevalence of sub-clinical ASCVD will be determined, and correlated with traditional and novel ASCVD risk factors; and 4) a prospective three-year follow-up of the 125 ESRD cases above to quantify the progression of sub-clinical ASCVD and its predictors. This application has been thoroughly revised in response to the previous review. The proposed study of observational research will fill a major gap in our understanding of cardiovascular disease of young adults in this high-risk ESRD population. The incidence of ASCVD and the prevalence of modifiable and unmodifiable ASCVD risk factors will aid in the development of risk stratification for young adults with ESRD. The information generated from this work is essential to design clinical trials to prevent ASCVD in young adults with ESRD. The career development plan and research project described in this application will build a foundation for a successful career as an independent investigator.

描述（根据应用程序改编） 候选人Rulan Parekh在Johns Hopkins University的教职员工 肾脏科，儿科和医学部门。她是 接受过成人和小儿肾脏的培训，并获得了 大学生物统计学和临床​​研究设计科学 密歇根州。她的目标是成为专注于心血管的临床医生 - 科学家 疾病和ESRD使用流行病学和生物统计学的工具。实现 这个目标，她设计了一项课程工作，以补充以前 培训，其中包括高级调查员的结构化指导，以及 监督，创新研究的行为。高级博士关卡课程 遗传和心血管流行病学以及其他主题还将被采用。这 结构化指导将在韦尔奇预防中心内进行 流行病学和临床研究。该中心桥接公立学校 健康和医学是一个非常丰富的研究和指导环境。 提出的研究培训工具包括：1）描述 美国肾脏数据的ESRD的年轻人的ASCVD危险因素 系统（USRDS）数据库； 2）分析年轻的ASCVD发病率 在五年的随访期间，成年人及其相关的风险因素； 3）一项案例对照研究，以比较亚行的患病率 约翰夫妇在125名18-35岁的年轻人中接受了ASCVD Hopkins/Gambro门诊透析单元与125岁匹配的I型DM相比 在约翰霍普金斯门诊中心接受治疗的控件。流行率 临床下动脉粥样硬化心血管疾病将由两种测量 颈动脉船多普勒超声检查的创新性非侵入性方法 评估颈动脉内膜内侧壁厚和ECG触发的螺旋CT 评估冠状动脉钙化的冠状血管。流行率 将确定次临界ASCVD，并与传统和 新颖的ASCVD风险因素； 4）125年的前瞻性随访 上面的ESRD病例，以量化亚行式ASCVD及其的进展 预测指标。 该应用程序已彻底修订了以前的 审查。拟议的观察研究研究将填补主要空白 我们对这种高风险的年轻人心血管疾病的理解 ESRD人口。 ASCVD的发生率以及可修改的发生率 ASCVD危险因素不可替代将有助于发展风险 ESRD的年轻人分层。从此产生的信息 工作对于设计临床试验以防止年轻人的ASCVD至关重要 与ESRD。事业发展计划和研究项目中描述了 申请将为成功的独立职业生涯奠定基础 研究者。