Modifiable and Biochemical Predictors and Consequences of Acute Kidney Injury

急性肾损伤的可修改和生化预测因子及后果

• 批准号: 8469031
• 负责人: Amanda Hyre Anderson
• 金额: $ 13.63万
• 依托单位: UNIVERSITY OF PENNSYLVANIA
• 依托单位国家: 美国
• 财政年份: 2011
• 资助国家: 美国
• 起止时间: 2011-09-01 至 2016-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8469031
• 关键词: Acceleration; Achievement; Acute Renal Failure with Renal Papillary Necrosis; Award; Biochemical; Body mass index; Businesses; Cardiovascular Diseases; Cardiovascular system; Chronic; Chronic Kidney Failure; Chronic Kidney Insufficiency; Cohort Studies; Communities; Comorbidity; Cox Proportional Hazards Models; Data; Data Set; Development Plans; Disease Progression; Diuretics; Doctor of Philosophy; Drug usage; End stage renal failure; Environment; Epidemiology; Faculty; Fellowship; Funding; Glomerular Filtration Rate; Goals; Growth; Homocysteine; Homocystine; Hospitalization; Hypotension; Individual; Inflammatory; Injury; Interleukin-6; Intervention; Investigation; Kidney; Kidney Diseases; Knowledge; Leadership; Liver Failure; Measures; Mentored Research Scientist Development Award; Mentors; Modeling; Morbidity - disease rate; National Institute of Diabetes and Digestive and Kidney Diseases; National Research Service Awards; Nephrology; Non-Steroidal Anti-Inflammatory Agents; Outcome; Participant; Pennsylvania; Positioning Attribute; Postdoctoral Fellow; Program Development; Proteins; Renal function; Renin-Angiotensin System; Reporting; Research; Research Infrastructure; Research Personnel; Research Project Grants; Resources; Risk; Risk Factors; Schools; Scientist; Septicemia; Severities; Severity of illness; Source; Statistical Methods; Structural Models; Time; Training; Universities; Update; adverse outcome; base; blood pressure regulation; cardiovascular disorder risk; career; career development; cohort; community setting; epidemiology study; experience; follow-up; glycemic control; improved; inflammatory marker; innovation; medical schools; member; modifiable risk; mortality; population based; programs; urinary

DESCRIPTION (provided by applicant): In this proposal for a Mentored Research Scientist Development Award (K01), Amanda Hyre Anderson, PhD, MPH, outlines her career goals, career development plan, environment, mentoring framework, and research project to examine modifiable and biochemical predictors and consequences of acute kidney injury (AKI) in chronic kidney disease (CKD). Dr. Anderson completed her master's and doctoral training in Epidemiology at Tulane University with numerous awards and honors, and finished a NRSA postdoctoral fellowship in Renal Epidemiology at the University of Pennsylvania School of Medicine. She is currently a Research Associate at Penn and a co-investigator on the Chronic Renal Insufficiency Cohort (CRIC) Study. Dr. Anderson plans to pursue a career as an independent investigator to study the epidemiology of AKI in CKD, characterization and prediction of kidney function decline over time, and insufficiently examined co-morbidities and outcomes (e.g., non-cardiovascular co-morbidities) associated with CKD. Her long-term goal is to hold a standing faculty position as an active investigator. To enable her transition from mentored scientist to independent investigator during the award period, Dr. Anderson will 1) seek an improved knowledge of renal disease through coursework and nephrology rounds, 2) pursue an expanded repertoire of sophisticated statistical methods through coursework and mentoring, 3) strengthen her leadership capabilities by completing a leadership development program through the Wharton School of Business and engaging in CRIC Study oversight activities, 4) leverage interactions with mentors and consultants to refine her research plan and support her career development, and 5) submit an R01 application to further her independent research program. The overall goal of the proposed K01 research project is to identify modifiable and biochemical risk factors for AKI, and to examine the impact of AKI on morbidity and mortality among a diverse group of extremely well- characterized CRIC participants with CKD. More specifically, the aims of the project are: 1) to examine poor glycemic control, inadequate control of blood pressure, elevated body mass index, and use of renin- angiotensin-system blockade, diuretics, and nonsteroidal anti-inflammatory drugs as modifiable risk factors for AKI in the setting of CKD, 2) to investigate inflammatory and kidney injury markers, as well as CKD severity, as risk factors for AKI in CKD, and 3) to examine the impact of AKI on subsequent mortality and morbidity in CKD. All proposed investigations will occur within the cohort framework of the CRIC Study utilizing Cox proportional hazards models, mixed effects growth curve models, and marginal structural models with time-updated exposures. An innovative mixed effects approach will be employed among CRIC participants who experience AKI during follow-up to compare the slope of kidney function decline before and after the AKI episode. This study will make possible the identification of potentially modifiable, and thus, clinically-actionable, risk factors for AKI, and improve our understanding of the impact of AKI on the course of CKD.

描述（由申请人提供）：在这项指导研究科学家发展奖（K01）的提案中，Amanda Hyre Anderson，PhD，MPH，MPH概述了她的职业目标，职业发展计划，环境，环境，指导框架和研究项目，以检查可修改和生物化学预测因素和急性肾脏伤害（AKI）在慢性儿童疾病中的影响。安德森（Anderson）博士在杜兰大学（Tulane University）完成了她的硕士和博士学位培训，并获得了许多奖项和荣誉，并在宾夕法尼亚大学医学院完成了NRSA肾脏流行病学博士学位奖学金。她目前是宾夕法尼亚州的研究助理，也是慢性肾功能不全队列（CRIC）研究的共同评估者。安德森（Anderson）博士计划从事独立研究者的职业，以研究CKD中AKI的流行病学，随着时间的推移的肾功能的表征和预测，以及与CKD相关的非脑血管血管造期和结果（例如，非核心血管血管co虫）的合并症和结果（例如，非核管血管库）。她的长期目标是担任积极调查员的常任教师。为了在颁奖期间从指导科学家到独立研究者的过渡，安德森博士将1）通过课程工作和肾脏学回合寻求对肾脏疾病的知识，2）2）通过课程和指导来追求扩展的统计方法的曲目，3）通过与她的领导能力相互竞争，通过促进领导力的发展，并通过企业的领导才能进行研究，并通过商业范围和疏远的范围来实现领导才能，并通过商业研究来实现领导力的发展，并通过商业范围进行竞争，并进行了cric nectign of Crics and cric insign of Cric and incigning of Cricgige and Insight）顾问改善了她的研究计划并支持她的职业发展，以及5）提交R01申请，以进一步进一步进行她的独立研究计划。拟议的K01研究项目的总体目标是确定AKI的可修改和生化危险因素，并检查AKI对具有CKD的极为良好特征的CRIC参与者对发病率和死亡率的影响。 More specifically, the aims of the project are: 1) to examine poor glycemic control, inadequate control of blood pressure, elevated body mass index, and use of renin- angiotensin-system blockade, diuretics, and nonsteroidal anti-inflammatory drugs as modifiable risk factors for AKI in the setting of CKD, 2) to investigate inflammatory and kidney injury markers, as well as CKD severity, as risk CKD中AKI的因素，以及3）检查AKI对CKD中随后的死亡率和发病率的影响。所有提出的研究都将发生在CRIC研究的队列框架内，利用COX比例危害模型，混合效应生长曲线模型以及随时间更新的暴露。在随访期间经历AKI的CRIC参与者中，将采用一种创新的混合效应方法，以比较AKI发作之前和之后的肾脏功能下降的斜率下降。这项研究将使AKI的潜在修改，临床上的风险因素的鉴定，并提高我们对AKI对CKD的影响的理解。