EPIDEMIOLOGY AND CLINICAL COURSE OF HIV NEPHROPATHY

HIV肾病的流行病学和临床病程

• 批准号: 6516744
• 负责人: LYNDA ANNE Marie SZCZECH
• 金额: $ 13.88万
• 依托单位: DUKE UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2000
• 资助国家: 美国
• 起止时间: 2000-06-01 至 2005-04-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6516744
• 关键词: HIV infections; adult human (21+); clinical research; disease /disorder proneness /risk; epidemiology; human subject; kidney disorder; longitudinal human study; pathologic process; proteinuria

DESCRIPTION (adapted from the application) This proposal for career development award for Lynda Szczech, MD will provide the didactic training and research experience necessary to make her a competitive and productive clinical investigator in the field of HIV-associated nephropathy (HIVAN). This proposal focuses on the epidemiology of HIV associated nephropathy (HIVAN). HIVAN is a complication of HIV infection that is associated with a 50% annual mortality. As demonstrated by the United States Renal Data Service, HIVAN is now the fourth leading cause of end-stage renal disease in African-Americans aged 20 to 64. This study will provide vital information on the risk factors and clinical course of this kidney disease that may be used subsequently to design strategies for prevention and treatment. This study will utilize a cross-sectional survey to study a large, population-based sample of HIV-infected patients to determine the prevalence of microalbuminuria and proteinuria and the risk factors for the development of HIVAN. The cohort of patients with microalbuminuria will be followed prospectively along with a sample of patients without evidence of renal disease to determine if the presence of microalbuminuria is predictive for the development of nephropathy or other outcomes such as mortality. Determination of the natural history of microalbuminuria may subsequently provide a noninvasive means to detect early disease or predict mortality. Prevention and treatment strategies focused on patients with microalbuminuria may definitively impact the burden of disease. This proposal will also study the effect of different anti-retroviral treatment regimens and clinical markers for the progression of HIV-infection such as plasma HIV RNA level or CD4 count on the progression of nephropathy. These effects will be explored using a retrospective cohort design among the patients with evidence of nephropathy identified in the cross-sectional survey and among patients enrolled in the Women's Interagency HIV Study. This information combined with our knowledge of renal pathophysiology and the progression of kidney diseases can then be used to design effective prevention and treatment strategies aimed at decreasing the morbidity and mortality associated with this devastating nephropathy.

描述（改编自应用程序） 这一建议的职业发展奖琳达Szczech，医学博士将提供 必要的教学培训和研究经验，使她成为一个 在HIV相关领域具有竞争力和生产力的临床研究者 肾病（HIV）。这项建议的重点是艾滋病毒的流行病学 相关性肾病（HIVAN）。HIVAN是HIV感染的并发症， 每年有50%的死亡率正如美国所证明的那样， 根据肾脏数据服务，HIVAN现在是终末期肾脏疾病的第四大原因。 20至64岁的非裔美国人的疾病。这项研究将提供重要的 关于这种肾脏疾病的风险因素和临床病程的信息， 随后可用于设计预防和治疗策略。 本研究将利用横断面调查研究一个大的， 对艾滋病毒感染者进行人口抽样，以确定 微量白蛋白尿和蛋白尿以及发生 HIVAN。将随访微量白蛋白尿患者队列 前瞻性沿着无肾病证据的患者样本 以确定微量白蛋白尿的存在是否预示着 肾病的发展或其他结果，如死亡。测定 微量白蛋白尿的自然史可能随后提供了一个 非侵入性手段来检测早期疾病或预测死亡率。预防和 针对微量白蛋白尿患者的治疗策略可能明确 影响疾病负担。本建议还将研究 不同的抗逆转录病毒治疗方案和临床标志物 HIV感染的进展，如血浆HIV RNA水平或CD4计数 肾病进展。这些影响将使用 在有肾病证据的患者中进行回顾性队列设计 在横断面调查中以及在参加 妇女机构间艾滋病毒研究。这些信息结合我们对 肾脏病理生理学和肾脏疾病的进展， 制定有效的预防和治疗战略， 发病率和死亡率与这种破坏性肾病相关。