Vitamin D hormones in CKiD: Prevalence of deficiency and clinical correlates.

CKiD 中的维生素 D 激素：缺乏症的患病率和临床相关性。

• 批准号: 7935267
• 负责人: Juhi Kumar
• 金额: $ 15.49万
• 依托单位: WEILL MEDICAL COLL OF CORNELL UNIV
• 依托单位国家: 美国
• 财政年份: 2009
• 资助国家: 美国
• 起止时间: 2009-09-21 至 2014-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7935267
• 关键词: 1,25 (OH) vitamin D; 14 year old; 25-hydroxyvitamin D; Adolescent; Adult; Age; Albuminuria; Apoptosis; Award; Blood Pressure; Calcium; Cardiovascular Diseases; Cardiovascular system; Cell Proliferation; Child; Childhood; Chronic Kidney Failure; Clinical; Clinical Investigator; Cohort Studies; Data; Databases; Development; Diagnosis; Dialysis procedure; Diet; Dihydroxycholecalciferols; Disease; Disease Progression; End stage renal failure; Enrollment; Enzymes; Epidemic; Epidemiologic Studies; Excretory function; Failure; Genes; Grant; Growth; Growth and Development function; Health; Height; Hemodialysis; High Prevalence; Homeostasis; Hormones; Hospitalization; Hypertension; Hypotension; Intake; Intestinal Absorption; K-Series Research Career Programs; Kidney; Kidney Diseases; Lead; Left Ventricular Hypertrophy; Lipids; Low Prevalence; Master' s Degree; Measurement; Measures; Mixed Function Oxygenases; Morbidity - disease rate; National Health and Nutrition Examination Survey; Neurocognitive; Nutritional; Outcome; Parathyroid Hormones; Participant; Patients; Phosphorus; Population; Prevalence; Principal Investigator; Proteinuria; Protocols documentation; Public Health; Questionnaires; Race; Renal Osteodystrophy; Research; Research Design; Research Personnel; Research Proposals; Risk Factors; Role; Secondary Hyperparathyroidism; Serum; Source; Sun Exposure; Time; United States; United States National Institutes of Health; Visit; Vitamin D; Vitamin D Deficiency; Vulnerable Populations; aged; angiogenesis; cardiovascular disorder risk; career; cohort; dietary supplements; fibroblast growth factor 23; human PTH protein; improved; inorganic phosphate; modifiable risk; mortality; novel; patient oriented research; programs; prospective; public health relevance; sex; skills

DESCRIPTION (provided by applicant): The aim of this career development award is to become an independent investigator in patient-oriented research involving children with chronic kidney disease (CKD). The prevalence of pediatric end stage renal disease (ESRD) is 86.1/million. Despite the low prevalence, pediatric CKD carries significant morbidity and mortality. The expected remaining lifetime for a child, 0-14 years of age and on dialysis is only 20 years. The focus of research in pediatric CKD should be identification of risk factors for progression. Chronic Kidney disease in children (CKiD) is a prospective cohort study of kidney disease in children and adolescents aged 1-16 years. The aims of this epidemiologic study are to determine the risk factors for progression of chronic kidney disease and its effects on cardiovascular health, growth and neurocognitive development. Low vitamin D levels have recently emerged as a potential risk factor for CKD progression, because of their association with higher blood pressure and albuminuria.FGF-23 is a novel hormone that is a negative regulator of 1,25 dihydroxy vitamin D levels and has been shown to have an association with mortality in adult ESRD patients. For the initial part of the research proposal, data from the CKiD study will be used to determine the prevalence and correlates of 25 hydroxy vitamin D (25OHD) and 1,25 di hydroxy vitamin D [1,25(OH)2D] deficiency. A questionnaire will be developed to assess the intake of 25OHD from nutritional and environmental sources. Prevalence and correlates of 25OHD deficiency will be compared between the CKiD cohort and age and race matched controls in the NHANES 2001-2004 database. We propose to measure the levels of 1,25 (OH)2D and FGF-23 hormones in the CKiD population. The associations of 1,25 (OH)2 D with the progression of CKD and growth delay will be determined. The last part of our study will examine the determinants of FGF-23 and explore its role in the dysregulation of vitamin D hormone axis, progression of CKD and growth delay in pediatric CKD. My determination to have a successful career in research started with obtaining a Master's degree in Public Health and the K23 grant will further help me to acquire skills necessary to fulfill my aim of becoming an independent clinical investigator. PUBLIC HEALTH RELEVANCE: End stage renal disease is a world wide epidemic. There is an urgent need to find novel risk factors that would delay progression and improve outcomes in CKD. This K-23 study proposal aims to elucidate the role of novel risk factors for chronic kidney disease progression in one of the most vulnerable population to be afflicted by this disease.

描述(由申请人提供)： 这个职业发展奖的目的是成为慢性肾脏疾病(CKD)儿童以患者为导向的研究的独立调查者。儿童终末期肾病(ESRD)患病率为86.1/百万。尽管患病率很低，但儿童慢性肾脏病的发病率和死亡率很高。0-14岁接受透析的儿童的预期剩余寿命只有20年。儿科慢性肾脏病的研究重点应该是确定疾病进展的危险因素。儿童慢性肾脏病(CKiD)是一项针对1-16岁儿童和青少年肾脏疾病的前瞻性队列研究。这项流行病学研究的目的是确定慢性肾脏疾病进展的危险因素及其对心血管健康、生长发育和神经认知发育的影响。最近，低维生素D水平被认为是CKD进展的潜在危险因素，因为它们与高血压和蛋白尿有关。成纤维细胞生长因子-23是一种新的激素，它是1，25二羟基维生素D水平的负调节因子，已被证明与成年ESRD患者的死亡率有关。在研究方案的最初部分，来自CKiD研究的数据将被用来确定25羟基维生素D(25OHD)和1，25二羟基维生素D[1，25(OH)2D]缺乏的患病率和相关性。将编制一份调查问卷，以评估从营养和环境来源摄取25OHD的情况。在NHANES 2001-2004数据库中，将比较CKiD队列和年龄和种族匹配的对照人群中25OHD缺乏症的患病率和相关性。我们建议在CKiD人群中检测1，25(OH)2D和FGF-23激素水平。1，25(OH)2D与CKD进展和生长延迟的关系将被确定。本研究的最后部分将研究成纤维细胞生长因子-23的决定因素，并探讨其在儿童慢性肾脏病中维生素D激素轴失调、慢性肾脏病进展和生长迟缓中的作用。我决心在研究领域取得成功，从获得公共卫生硕士学位开始，并获得K23奖学金，这将进一步帮助我获得必要的技能，以实现我成为一名独立临床研究员的目标。 公共卫生相关性：终末期肾病是一种世界性的流行病。迫切需要找到新的危险因素，以延缓CKD的进展并改善预后。这项K-23研究建议旨在阐明新的危险因素在慢性肾脏疾病进展中的作用，该人群是受这种疾病困扰的最脆弱的人群之一。