Chronic Kidney Disease, Vascular Disease and Aging

描述(由申请人提供)： 慢性肾脏疾病(CKD)是一个公共卫生问题，在美国约有2000万人受到影响。众所周知，慢性肾脏病对心血管系统、衰老过程以及认知功能都有不利影响。这项K24计划的目的是为Sarnak博士的以患者为导向的研究(POR)计划提供支持，并在这些主题上为他的受训人员提供指导。萨纳克博士目前作为首席研究员得到了三项联邦拨款的支持，其中包括1.肾脏疾病汇集项目中的心血管风险因素2.心血管健康研究中的肾脏疾病，这是一项针对老年人的队列研究，以及3.透析患者中的认知和血管疾病。这三项研究以及各种各样的其他多中心合作为Sarnak博士的受训者提供了产生假设和独立研究的机会。自2000年以来，萨纳克指导了15名住院医生或研究员，并以他的被导师为第一作者，担任21篇同行评议文章的资深作者。他之前的三名学员目前是POR和新英格兰塔夫茨医学中心肾脏科的成员。他的受训者将得到T32国家研究服务奖(NRSA DK007777)的支持，以及目前和未来授予肾脏病学部的K23奖。Sarnak博士是T32 NRSA的副主任。所有受训人员将完成1)完成塔夫茨大学萨克勒生物医学研究生院临床研究研究生项目硕士学位的教学培训课程工作。2)独立研究--一个基于假设的研究项目，由一名Sarnak博士和一个在其他学科有专长的教员研究团队监督；3)演讲培训--参加旨在提高受训者口头和书面陈述能力的会议和研讨会。由Sarnak博士指导的K23获奖者也参与了他的研究团队和指导，为培训新的临床医生-研究人员创造了一个出色的环境。 这项申请还包括一项新的建议，对肾脏疾病中修改饮食(MDRD)研究的随机和非随机队列进行长期跟踪，其广泛目标是评估肾衰竭时的肾衰竭、低蛋白血症和心血管疾病的风险因素，以及在15年的随访中所有原因的死亡。 慢性肾脏病是一个流行病规模的公共卫生问题，在发病率、死亡率和资源利用方面具有深远的影响。预防和延缓CKD的发展和进展，以及与其相关的并发症，如心血管疾病、不成功的衰老和认知异常的发展，可能会影响国民的健康，降低医疗成本。对未来的POR调查人员进行培训对于减轻未来CKD的负担至关重要。

DESCRIPTION (provided by applicant): Chronic kidney disease (CKD) is a public health problem with ~20 million affected in the US. CKD is known to have adverse effects on the cardiovascular system, the aging process as well as cognitive function. The aim of this K24 program is provide support for Dr. Sarnak's patient oriented research (POR) program and mentorship for his trainees in these topics. Dr. Sarnak is currently supported as the Principal Investigator though three Federal grants including those from the 1. The Cardiovascular Risk Factors in Kidney Disease Pooling Project 2. Kidney Disease in the Cardiovascular Health Study, a cohort study of older adults and 3. Cognition and Vascular Disease in Dialysis Patients. These three studies as well as a wide variety of other multicenter collaborations provide opportunities for hypothesis generation and independent research for Dr Sarnak's trainees. Since 2000 Dr. Sarnak has mentored 15 residents or research fellows, and been senior author on 21 peer-reviewed articles with his mentee as the first author. Three of his previous mentees are currently POR's and members of the Division of Nephrology at Tufts New England Medical Center. His mentees would be supported by a T32 National Research Service Award (NRSA DK007777), as well as current and future K23 awards that have been awarded to Division of Nephrology. Dr. Sarnak is the Associate Director of the T32 NRSA. All trainees would complete 1) Didactic Training - course work in fulfillment of the MS degree in the Graduate Program in Clinical Research at the Sackler School of Graduate Biomedical Sciences at Tufts University. 2) Independent Study - an hypothesis-based research project supervised by a Dr. Sarnak and a research team of faculty with expertise in other disciplines and 3) Training in Presentation - participation in conferences and seminars designed to improve trainees' oral and written presentations. K23 awardees mentored by Dr. Sarnak also participate on his research team and in mentoring, creating an outstanding environment for training new clinician-investigators. This application also includes a new proposal for long term follow up of the randomized and non randomized cohorts of the Modification of Diet in Renal Disease (MDRD) Study with the broad aims of evaluating risk factors for kidney failure, hypoalbuminemia and cardiovascular disease at the time of kidney failure, and all cause mortality in 15 years of follow-up. CKD is a public health problem of epidemic proportions with profound implications in terms of morbidity, mortality and resource utilization. Preventing the development and retarding the progression of CKD, as well as its associated complications such as cardiovascular disease, unsuccessful aging and development of cognitive abnormalities, will potentially impact the health of the nation and reduce health care costs. Training future investigators in POR will be essential to reduce the burden of CKD in the future.