Chronic Kidney Disease, Vascular Disease and Aging

描述（由申请人提供）： 慢性肾脏病（CKD）是一种公共卫生问题，在美国约有2000万人受到影响。已知CKD对心血管系统、衰老过程以及认知功能具有不利影响。该K24计划的目的是为Sarnak博士的患者导向研究（POR）计划提供支持，并为这些主题的学员提供指导。Sarnak博士目前作为主要研究者获得三项联邦赠款，包括来自1.肾脏疾病合并项目中的心血管危险因素2。心血管健康研究中的肾脏疾病，一项老年人队列研究和3。透析患者的认知与血管疾病。这三项研究以及其他各种多中心合作为Sarnak博士的学员提供了假设生成和独立研究的机会。自2000年以来，Sarnak博士指导了15名住院医生或研究员，并以他的导师为第一作者，担任21篇同行评议文章的资深作者。他以前的三个学员目前是POR的和塔夫茨新英格兰医学中心肾脏科的成员。他的学员将获得T32国家研究服务奖（NRSA DK 007777），以及目前和未来授予肾脏科的K23奖项的支持。Sarnak博士是T32 NRSA的副主任。所有学员将完成1）教学培训-塔夫茨大学萨克勒生物医学研究生院临床研究生课程硕士学位的课程工作。2)独立研究-由Sarnak博士和具有其他学科专业知识的教师研究团队监督的基于假设的研究项目; 3）演示培训-参加旨在提高学员口头和书面演示的会议和研讨会。Sarnak博士指导的K23获奖者还参加了他的研究团队和指导，为培训新的临床研究人员创造了良好的环境。 本申请还包括一项对肾脏疾病饮食改良（MDRD）研究的随机和非随机队列进行长期随访的新提议，其广泛目的是评价肾衰竭、肾衰竭时的低白蛋白血症和心血管疾病的风险因素，以及15年随访期间的全因死亡率。 CKD是一种流行性的公共卫生问题，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的发展及其相关并发症，如心血管疾病，不成功的衰老和认知异常的发展，将可能影响国民的健康并降低医疗保健成本。对未来的研究者进行POR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.