Gender Disparities and Vascular Function in Chronic Kidney Disease Outcomes

慢性肾脏病结果中的性别差异和血管功能

• 批准号: 8441885
• 负责人: Ana Catherine Ricardo
• 金额: $ 16.56万
• 依托单位: UNIVERSITY OF ILLINOIS AT CHICAGO
• 依托单位国家: 美国
• 财政年份: 2013
• 资助国家: 美国
• 起止时间: 2013-05-01 至 2018-02-28
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8441885
• 关键词: Abstinence; Achievement; Address; Adherence; Adult; Affect; Age; Angiotensin-Converting Enzyme Inhibitors; Area; Atherosclerosis; Award; Behavior Therapy; Biological; Blood Pressure; Blood Vessels; Cardiovascular Diseases; Cardiovascular system; Chicago; Chronic Kidney Failure; Chronic Kidney Insufficiency; Clinical; Clinical Sciences; Cohort Studies; Data; Data Analyses; Data Collection; Development; Development Plans; Diabetes Mellitus; Disease Outcome; Disease Progression; Doctor of Philosophy; Educational Intervention; End stage renal failure; Epidemiology; Estrogens; Ethnic Origin; Event; Exercise; Foundations; Functional disorder; Funding; Gender; General Population; Glucose; Goals; Guidelines; Health Services Accessibility; Health behavior; High Prevalence; Illinois; Impairment; Incidence; Individual; Information Systems; Intervention; K-Series Research Career Programs; Kidney; Kidney Diseases; Knowledge; Lead; Life Style; Lipids; Measures; Mediating; Mentored Patient-Oriented Research Career Development Award; Mentors; Mentorship; Methodology; Minority; Minority Groups; National Health and Nutrition Examination Survey; National Institute of Diabetes and Digestive and Kidney Diseases; Observational Study; Outcome; Participant; Patients; Performance; Physical Function; Physicians; Physiologic pulse; Pilot Projects; Population; Prevalence; Public Health; Public Health Schools; Race; Research; Research Infrastructure; Research Personnel; Resistance; Resources; Risk Factors; Role; Sampling; Scientist; Sex Characteristics; Smoking; Testing; Time; Training; Translational Research; United States; United States National Institutes of Health; Universities; Woman; Women' s Health; blood pressure regulation; cardiovascular risk factor; career; career development; design; diet and exercise; experience; health disparity; health inequalities; improved; lifestyle intervention; men; mortality; multidisciplinary; protective effect; public health relevance; skills

DESCRIPTION (provided by applicant): The candidate for this Mentored Patient-Oriented Research Career Development Award (K23) is Ana C. Ricardo, MD, MPH, a nephrologist at the University of Illinois at Chicago (UIC). Dr. Ricardo's short-term goals are to gain experience and develop skills by conducting research focused on gender disparities in chronic kidney disease (CKD), and the contribution of gender differences in endothelial function to these disparities. Her long-term career goals are to become an independent investigator conducting research focused on reducing health inequalities in CKD through lifestyle interventions. To achieve her goals, Dr. Ricardo has assembled a comprehensive career development plan that consists of mentored research and didactic coursework at the UIC School of Public Health. Dr. Ricardo's strong team of mentors and collaborators includes world-class experts with longstanding NIH funding and extensive mentorship experience. Her primary mentor, James P. Lash, MD, is an expert in the epidemiology of CKD in minority populations; Martha L. Daviglus, MD, PhD, her co-mentor, has expertise in the epidemiology of cardiovascular disease. The proposal also includes a multidisciplinary team of collaborators with expertise in the areas of women's health, longitudinal data analyses, and the influence of exercise on vascular function. Dr. Ricardo's successful development into an independent physician-scientist will be facilitated by the extensive facilities and resources available at UIC which include the Clinical and Translational Science Award, the Center for Research on Women and Gender, and the School of Public Health. Dr. Ricardo's research will advance her skills in both primary data collection and longitudinal data analyses. The proposal leverages the infrastructure of the NIH- funded Chronic Renal Insufficiency Cohort (CRIC) Study, a large and diverse observational study of adults with CKD. Evidence suggests that there are significant gender-related disparities in CKD. Whereas data from the United States Renal Data System indicate that men have 1.5 times greater incidence of end-stage renal disease, a higher prevalence of CKD in women was seen in the National Health and Nutrition Examination Survey. Several studies suggest that men have more rapid CKD progression, but this has not been a consistent finding. Furthermore, previous studies were not designed to address this question and included few racial/ethnic minorities. In the general population, there is evidence that differential rates of cardiovascular outcomes in women and men may be related to gender differences in endothelial function, which have been in part attributed to the protective effect of estrogen in women. Moreover, limited data suggest that endothelial dysfunction may be a predictor of CKD progression. However, the contribution of endothelial function to gender disparities in CKD progression is not known. This is an area of significance because studies of non-CKD populations suggest that endothelial function may be improved with pharmacologic therapy (e.g., ACE- inhibitors) or lifestyle interventions (e.g., exercise). The specific aims for the proposed project are to 1) Examine gender disparities in kidney and cardiovascular outcomes in the CRIC Study; 2) Examine gender differences in endothelial function and the role of endothelial function as a predictor of CKD progression in 150 University of Illinois CRIC Study participants; and 3) Evaluate the feasibility of a 12-week pilot resistance exercise training intervention and its effect on endothelial function and cardiovascular risk factors in men and women with CKD. This Career Development Award will provide the foundation for Dr. Ricardo to pursue an independent research career dedicated to reducing health disparities in CKD.

描述（由申请人提供）：这个指导患者为导向的研究职业发展奖（K23）的候选人是安娜C。Ricardo，医学博士，公共卫生硕士，伊利诺伊大学芝加哥分校（UIC）的肾病学家。Ricardo博士的短期目标是通过研究慢性肾脏病（CKD）的性别差异以及内皮功能的性别差异对这些差异的贡献来获得经验和发展技能。她 长期职业目标是成为一名独立的研究者，通过生活方式干预减少CKD中的健康不平等。为了实现她的目标，里卡多博士已经组装了一个全面的职业发展计划，其中包括指导研究和教学课程在公共卫生的UIC学校。里卡多博士强大的导师和合作者团队包括世界一流的专家，他们拥有长期的NIH资助和丰富的导师经验。她的主要导师James P. Lash医学博士是少数民族CKD流行病学专家;她的共同导师Daviglus，MD，PhD，具有心血管疾病流行病学方面的专业知识。该提案还包括一个多学科的合作者小组，在妇女健康、纵向卫生和生殖健康等领域具有专门知识。 数据分析，以及运动对血管功能的影响。里卡多博士的成功发展成为一个独立的物理学家，科学家将促进广泛的设施 UIC的资源包括临床和转化科学奖，妇女和性别研究中心以及公共卫生学院。里卡多博士的研究将提高她在原始数据收集和纵向数据分析方面的技能。该提案利用了NIH资助的慢性肾功能不全队列（CRIC）研究的基础设施，这是一项针对CKD成人的大型多样性观察性研究。有证据表明，CKD存在显著的性别差异。美国肾脏数据系统的数据表明，男性终末期肾病的发病率是男性的1.5倍，而在国家健康和营养检查调查中，女性CKD的患病率更高。一些研究表明，男性CKD进展更快，但这并不是一个一致的发现。此外，以前的研究不是为了解决这个问题，包括少数种族/族裔。在一般人群中，有证据表明，女性和男性心血管结局的差异率可能与内皮功能的性别差异有关，这部分归因于女性雌激素的保护作用。此外，有限的数据表明，内皮功能障碍可能是CKD进展的预测因子。然而，内皮功能对CKD进展中性别差异的贡献尚不清楚。这是一个重要的领域，因为对非CKD人群的研究表明，内皮功能可以通过药物治疗（例如，ACE抑制剂）或生活方式干预（例如，锻炼）。拟议项目的具体目标是：1）在CRIC研究中检查肾脏和心血管结局的性别差异; 2）在150名伊利诺伊大学CRIC研究参与者中检查内皮功能的性别差异以及内皮功能作为CKD进展预测因子的作用;评估为期12周的飞行员抗阻运动干预的可行性及其对内皮功能和心血管的影响 CKD男性和女性的危险因素。该职业发展奖将为Ricardo博士提供基础，以从事独立的研究事业，致力于减少CKD的健康差异。