Renal Morbidity Following Kidney Cancer Surgery

肾癌手术后的肾脏发病率

• 批准号: 7961124
• 负责人: John Thomas Leppert
• 金额: $ 15.21万
• 依托单位: STANFORD UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2010
• 资助国家: 美国
• 起止时间: 2010-09-15 至 2015-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7961124
• 关键词: Award; Cancer Control; Cardiovascular system; Chronic Kidney Failure; Clinical; Clinical Research; Comorbidity; Diagnosis; End stage renal failure; Epidemiology; Event; Excision; Goals; Gold; Health Services Research; Healthcare Systems; Heart failure; High Prevalence; Hospitalization; Hypertension; Incidence; Kidney; Kidney Neoplasms; Malignant Neoplasms; Medical; Morbidity - disease rate; Myocardial Infarction; Nephrectomy; Nephrons; Operative Surgical Procedures; Outcome; Patient Care; Patients; Peripheral arterial disease; Persons; Postoperative Period; Registries; Renal Cell Carcinoma; Renal Mass; Renal carcinoma; Renal function; Reporting; Research Personnel; Risk; Stroke; Training; Universities; Veterans; anticancer research; base; cancer surgery; clinical care; cohort; comparative effectiveness; disorder risk; electronic data; improved; kidney cortex; mortality; programs; public health relevance; standard care; tumor; urologic

DESCRIPTION (provided by applicant): The impact of significant loss of renal mass resultant from kidney cancer surgery is not fully known. Large clinical studies demonstrate that loss of kidney function correlates with an increased incidence of hospitalizations, cardiovascular events, and all-cause mortality. Patients with renal cell carcinoma (RCC) tend to be older, often have co-morbid conditions associated with lower baseline kidney function, and may be particularly sensitive to further loss of kidney function following kidney cancer surgery. Hence, there is a great need to determine the comparative effectiveness of alternative surgical approaches for RCC on kidney function and downstream clinical outcomes. The goal of this award period is for Dr. Leppert to achieve complete independence as an investigator in urologic health services research and expertise in RCC clinical outcomes. He will receive extensive training through the Clinical Research Track in the Graduate Program in Epidemiology at Stanford University, and through the specific aims of the project. The broad objective of this study is to determine the effect of kidney cancer surgery on kidney function and outcomes associated with chronic kidney disease (CKD) such as end-stage renal disease (ESRD), cardiovascular events, hospitalizations, and mortality. The specific aims of the project are to 1) establish an electronic data registry of persons that underwent kidney cancer surgery within the Veterans Affairs (VA) health care system, 2) characterize the change of kidney function due to specific types of kidney cancer surgery, and 3) to correlate the type of kidney cancer surgery received and post-operative kidney function with the risk of ESRD, conditions associated with CKD, cardiovascular events, hospitalizations, and all-cause mortality among RCC patients in the VA health care system. Ultimately, comparing these surgical strategies can provide opportunities to improve care for patients diagnosed with RCC. PUBLIC HEALTH RELEVANCE: The impact of kidney cancer surgery on chronic kidney disease and its associated clinical outcomes is not fully known. Comparing the effect of kidney cancer surgery on kidney function will help inform treatment decisions and provide opportunities to improve care and clinical outcomes for patients diagnosed with kidney cancer.

描述（由申请人提供）：肾癌手术导致的肾质量显着损失的影响尚不完全清楚。大型临床研究表明，肾功能丧失与住院、心血管事件和全因死亡率增加相关。肾细胞癌 (RCC) 患者往往年龄较大，通常患有与基线肾功能较低相关的共病，并且可能对肾癌手术后肾功能的进一步丧失特别敏感。因此，非常需要确定肾细胞癌替代手术方法对肾功能和下游临床结果的比较有效性。该奖项期的目标是让 Leppert 博士作为泌尿科健康服务研究和 RCC 临床结果专业知识的研究者实现完全独立。他将通过斯坦福大学流行病学研究生项目的临床研究轨道以及该项目的具体目标接受广泛的培训。本研究的主要目标是确定肾癌手术对肾功能以及与慢性肾脏病 (CKD) 相关的结局的影响，例如终末期肾病 (ESRD)、心血管事件、住院治疗和死亡率。该项目的具体目标是 1) 为退伍军人事务部 (VA) 医疗保健系统内接受肾癌手术的人员建立电子数据登记册，2) 描述特定类型肾癌手术导致的肾功能变化特征，3) 将接受的肾癌手术类型和术后肾功能与 ESRD 风险、CKD 相关病症、心血管事件、住院治疗和住院治疗联系起来。 VA 医疗保健系统中 RCC 患者的全因死亡率。最终，比较这些手术策略可以为改善诊断为肾细胞癌的患者的护理提供机会。 公众健康相关性：肾癌手术对慢性肾脏病及其相关临床结果的影响尚不完全清楚。比较肾癌手术对肾功能的影响将有助于为治疗决策提供信息，并为改善诊断为肾癌的患者的护理和临床结果提供机会。