Acute Kidney Failure in a Cancer ICU

癌症 ICU 中的急性肾衰竭

• 批准号: 7034020
• 负责人: JOSHUA A SAMUELS
• 金额: $ 12.39万
• 依托单位: UNIVERSITY OF TEXAS HLTH SCI CTR HOUSTON
• 依托单位国家: 美国
• 财政年份: 2006
• 资助国家: 美国
• 起止时间: 2006-07-01 至 2011-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7034020
• 关键词: acute renal failure; cancer complication; cancer registry /resource; clinical research; disease /disorder onset; disease /disorder proneness /risk; environmental exposure; gene environment interaction; genetic markers; genetic polymorphism; genetic susceptibility; genotype; hospital length of stay; human data; human mortality; human population study; human subject; intensive care; mass spectrometry; mathematical model; model design /development; neoplasm /cancer; outcomes research; patient oriented research; prognosis

DESCRIPTION (provided by applicant): This proposal is for a Mentored Clinical Training Award (K23) for Dr. Joshua Samuels. The goal of this research is to provide career development and experience necessary to become a competitive independent clinical investigator, and to gain important knowledge regarding the development and outcome of acute kidney failure (AKF). The research will include patients admitted to the intensive care unit at MD Anderson Cancer Center (MDACC). Having already completed an MPH concentrating in Epidemiology, his didactic development plan includes Ph.D. level coursework at the UT-Houston School of Public Health, a period of laboratory training to gain facility with molecular epidemiology, and structured mentoring from two highly successful investigators. The protocol for the research is designed to facilitate his growth as a clinician-scientist and to evaluate clinical and genetic factors associated with AKF in critically ill patients with cancer. Cancer has become a leading cause of morbidity and mortality,with increasing hospitalization. AKF affects over 50,000 hospitalized Americans each year, and the mortality of patients with AKF in intensive care units has been reported as high as 86%. Current predictive models are inadequate to provide individualized prognostication. This study aims to refine predisposing clinical exposures and evaluate genetic markers that predict the onset and prognosis of AKF in critically ill cancer patients. The first phase uses a retrospective case-control design. Logistic and Cox regression modeling will be used to evaluate demographic and environmental exposure factors independently and in multivariate fashion to produce a final prediction model. Mortality and length of stay information will also be collected to evaluate associations between exposures and outcome. The second phase will prospectively validate the new clinical models and go further by evaluating multiple genetic polymorphisms as factors associated with AKF. The innovative addition of genetic analysis may provide enough improvement to allow patient specific prognostication. Overall, this study will allow for better prediction of AKF in ICU patients and better prognostication of their outcome. A better understanding of the risk factors and genetic susceptibility will allow quicker recognition of AKF and aid future research to develop more effective prevention or treatment options. The projects will launch the candidate into a career as an independent clinical investigator in Nephrology.

描述(由申请人提供)： 这项建议是为约书亚·塞缪尔博士设立临床培训导师奖(K23)。这项研究的目标是提供必要的职业发展和经验，成为一名有竞争力的独立临床研究员，并获得关于急性肾功能衰竭(AKF)的发展和结局的重要知识。这项研究将包括住进MD安德森癌症中心(MDACC)重症监护病房的患者。在完成了专注于流行病学的公共卫生硕士学位后，他的教学发展计划包括在德克萨斯大学休斯顿公共卫生学院进行博士水平的课程学习，一段时间的实验室培训以获得分子流行病学方面的技能，以及两名非常成功的研究人员的结构化指导。这项研究的方案旨在促进他作为临床科学家的成长，并评估与癌症危重患者AKF相关的临床和遗传因素。随着住院人数的增加，癌症已成为发病率和死亡率的主要原因。AKF每年影响50,000多名住院美国人，据报道，重症监护病房中AKF患者的死亡率高达86%。目前的预测模型不足以提供个性化的预测。这项研究的目的是改进易患临床暴露的因素，并评估预测危重癌症患者AKF发病和预后的遗传标记。第一阶段采用回溯性病例对照设计。Logistic和Cox回归模型将被用来独立地和以多变量的方式评估人口和环境暴露因素，以产生最终的预测模型。还将收集死亡率和住院时间信息，以评估暴露与结果之间的关联。第二阶段将前瞻性地验证新的临床模型，并进一步评估与AKF相关的多种基因多态。基因分析的创新性增加可能会提供足够的改进，以实现患者的特异性预测。总体而言，这项研究将允许更好地预测ICU患者的AKF，并更好地预测他们的结果。更好地了解风险因素和遗传易感性将有助于更快地认识AKF，并有助于未来的研究开发更有效的预防或治疗方案。这些项目将使候选人进入肾脏病独立临床研究员的职业生涯。