Predictors and Impact of Low GFR After Living Kidney Donation

活体肾脏捐赠后低 GFR 的预测因素和影响

• 批准号: 7452452
• 负责人: Elizabeth Ommen
• 金额: $ 13.75万
• 依托单位: ICAHN SCHOOL OF MEDICINE AT MOUNT SINAI
• 依托单位国家: 美国
• 财政年份: 2007
• 资助国家: 美国
• 起止时间: 2007-07-01 至 2012-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7452452
• 关键词: Area; Blood Donations; Blood Pressure; Blood Tests; Body mass index; C-reactive protein; Cardiovascular system; Characteristics; Chronic Kidney Failure; Clinical; Clinical Research; Collection; Creatinine; Cross-Sectional Studies; Data; Data Collection; Databases; Deterioration; Development; Eligibility Determination; End stage renal failure; Epidemiologic Studies; Epidemiology; Ethnic Origin; Evaluation; Event; Exclusion; Exclusion Criteria; Foundations; Funding; Future; Glomerular Filtration Rate; Goals; Health; Hispanics; Hour; Hypertension; Incidence; Individual; Informed Consent; Invasive; Kidney; Kidney Diseases; Kidney Failure; Life; Lipids; Living Donors; Long-Term Effects; Longitudinal Studies; Low Prevalence; Master of Science; Measurement; Measures; Medical; Medical center; Mentors; Mentorship; Minority; Monitor; Nephrectomy; Numbers; Outcome; Pattern; Personal Satisfaction; Phenotype; Policies; Population; Population Control; Population Heterogeneity; Predisposition; Presbyterian Church; Principal Investigator; Process; Prospective Studies; Purpose; Race; Renal function; Reporting; Research; Research Personnel; Risk; Risk Factors; Sample Size; Testing; Training; Transplantation; United States; Urine; Visit; base; cardiovascular risk factor; clinical phenotype; comparison group; experience; follow-up; improved; insight; patient oriented research; programs; statistics; urinary

DESCRIPTION (provided by applicant): In the past decade, as the incidence of end-stage renal disease has grown and the number of cadaveric kidneys has remained stagnant, there has been a dramatic increase in the use of living kidney donors. Several studies and our preliminary data have demonstrated a subset of donors with unexpectedly poor renal function post-donation. These donors thus meet criteria for chronic kidney disease (CKD). The clinical implications of low GFR in living donors is unclear, however epidemiologic studies have found that individuals with CKD have a greater deterioration in renal function and a greater number of cardiovascular (CV) events; this also coincides with the increased presence of markers of renal and CV risk. We hypothesize that kidney donation confers an increased risk of long-term renal and cardiovascular complications in a subset of donors who develop a low GFR post-donation. We further hypothesize that there are specific risk factors for developing a low GFR post-donation that are readily identifiable prior to donation. To test these hypotheses, we propose 2 complementary studies: 1. A retrospective/cross-sectional study of donors between 1 and 6 years post-donation. 2. A prospective study of donors and non-donor controls, followed for up to 5 years. We will examine risk factors for renal progression and CV events in living donors to determine whether GFR <60 places donors at increased risk. These will include ambulatory blood pressure, urinary microalbumin, lipid profile, C-reactive protein, and endothelial function. This will provide early data about possible future risks in this subset of donors, and offer insight into the mechanisms of risk in CKD. Donor phenotypes that may increase the risk of low post-donation GFR have not been well-explored, and have not been evaluated in a racially and ethnically diverse population. We will assess potential predictors of a post-donation GFR of <60, including race, ethnicity, pre-donation blood pressure, and pre-donation body mass index. This information may be used to establish evidence-based exclusion criteria for donation and to improve the informed consent process. This study of living kidney donors will supply valuable information on the medical risks of uninephrectomy in a diverse population, and will contribute to the development of data-driven policies for living kidney donation. The primary purpose of this application is to support the candidate, Dr. Elizabeth Ommen as she develops into an independent investigator in the areas of renal disease and hypertension, with an emphasis on minority populations. She will supplement the formal training in clinical research that she has already received with more advanced courses in epidemiology and statistics. Her mentors will use their research

描述（由申请人提供）：