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Acute Kidney Failure in a Cancer ICU

癌症 ICU 中的急性肾衰竭

基本信息

批准号：
7922716
负责人：
JOSHUA A SAMUELS
金额：
$ 12.42万
依托单位：
UNIVERSITY OF TEXAS HLTH SCI CTR HOUSTON
依托单位国家：
美国
项目类别：
财政年份：
2006
资助国家：
美国
起止时间：
2006-07-01 至 2012-06-30
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/7922716
关键词：
Acute Kidney Failure Affect American Blood Vessels Cancer Center Cancer Patient Candidate Disease Gene Clinical Clinical Investigator Cohort Studies Critical Illness Data Development Development Plans Doctor of Philosophy Environmental Exposure Epidemiology Evaluation FarGo Future Genes Genetic Genetic Markers Genetic Polymorphism Genetic Predisposition to Disease Genotype Goals Growth Hospitalization Immune response Individual Inflammation Intensive Care Units Knowledge Laboratories Length of Stay Logistics Malignant Neoplasms Medical Mentored Patient-Oriented Research Career Development Award Mentors Modeling Molecular Epidemiology Morbidity - disease rate Nephrology Operative Surgical Procedures Outcome Outcome Study Patients Phase Prevention Principal Investigator Protocols documentation Public Health Schools Reporting Research Research Design Research Personnel Risk Risk Factors Scientist Structure Training Variant career career development case control cohort design experience genetic analysis improved innovation mortality outcome forecast patient population physiologic model predictive modeling programs prospective response

项目摘要

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）：本提案旨在为约书亚塞缪尔博士颁发指导临床培训奖（K23）。本研究的目标是提供职业发展和经验，成为一个有竞争力的独立临床研究者，并获得有关急性肾衰竭（AKF）的发展和结果的重要知识。该研究将包括MD安德森癌症中心（MDACC）重症监护室的患者。他已经完成了流行病学硕士学位，他的教学发展计划包括博士学位。在德州大学休斯顿公共卫生学院完成了一系列高级课程，进行了一段时间的实验室培训，以获得分子流行病学方面的知识，并从两位非常成功的研究人员那里获得了结构化的指导。该研究的方案旨在促进他作为临床科学家的成长，并评估与癌症重症患者AKF相关的临床和遗传因素。随着住院治疗的增加，癌症已成为发病率和死亡率的主要原因。AKF每年影响超过50，000名住院的美国人，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解释。本研究的目的是完善易感的临床暴露和评估遗传标记，预测危重癌症患者AKF的发病和预后。第一阶段采用回顾性病例对照设计。将使用Logistic和考克斯回归模型以多变量方式独立评价人口统计学和环境暴露因素，以生成最终预测模型。还将收集死亡率和住院时间信息，以评价暴露与结局之间的相关性。第二阶段将前瞻性地验证新的临床模型，并进一步评估多种遗传多态性作为与AKF相关的因素。基因分析的创新性增加可以提供足够的改善，以允许患者特异性诊断。总的来说，这项研究将更好地预测ICU患者的AKF，并更好地说明其结局。更好地了解风险因素和遗传易感性将有助于更快地识别AKF，并有助于未来的研究开发更有效的预防或治疗方案。这些项目将启动候选人进入职业生涯作为一个独立的临床研究者在肾脏病。