Malnutrition, Diet and Racial Disparities in CKD

慢性肾病的营养不良、饮食和种族差异

• 批准号: 8675848
• 负责人: Kamyar Kalantar-Zadeh
• 金额: $ 17.53万
• 依托单位: UNIVERSITY OF CALIFORNIA-IRVINE
• 依托单位国家: 美国
• 财政年份: 2011
• 资助国家: 美国
• 起止时间: 2011-06-01 至 2016-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8675848
• 关键词: Acquired Immunodeficiency Syndrome; Actins; African American; American; Ancillary Study; Anemia; Area; Asian Americans; Award; Biological Markers; Biology; Blood; Blood Vessels; Body Composition; Cachexia; California; Cardiac; Cardiovascular system; Caring; Cell Adhesion Molecules; Chronic; Chronic Disease; Chronic Kidney Failure; Chronic lung disease; Clinic; Clinical; Clinical Research; Cohort Studies; Collaborations; Constitutional; County; Data; Databases; Dialysis patients; Dialysis procedure; Diet; Diet and Nutrition; Dietary intake; Disease; Disease Progression; Doctor of Philosophy; Eating; Elderly; Epidemiology; Ethnic Origin; Ethnic group; Event; Exhibits; Faculty; Food; Frequencies; Future; Gelsolin; Genetic; Genetic Polymorphism; Goals; Health; Heart failure; Hemodialysis; Hispanic Americans; Hispanics; Indigent; Inflammation; Inflammatory; Kidney Diseases; Laboratories; Lead; Life; Link; Liver diseases; Malignant Neoplasms; Malnutrition; Measures; Medicine; Mentors; Mentorship; Methods; Mexican Americans; Mid-Career Clinical Scientist Award (K24); Minerals; Minority; Not Hispanic or Latino; Nutrient; Nutrition Assessment; Nutritional; Nutritional Study; Nutritional status; Outcome; Pathway interactions; Patient Care; Patients; Pediatrics; Perception; Plant Roots; Platelet Activation; Population; Prospective Studies; Proteins; Psyche structure; Public Health; Quality of life; Questionnaires; Race; Recruitment Activity; Research; Research Personnel; Risk; Role; Schools; Specimen; Stratification; Stress; System; Techniques; Testing; Time; Training; Universities; bone; burden of illness; career; cohort; coping; improved; medical schools; mortality; novel; nutrition; patient oriented; patient oriented research; professor; prospective; psychosocial; racial and ethnic; racial and ethnic disparities; residence; social; wasting

DESCRIPTION (provided by applicant): The purpose of this Mid-Career Investigator Award in "Malnutrition, Diet and Racial Disparities in CKD" by Kamyar Kalantar-Zadeh, MD, MPH, PhD, Associate Professor-in-Residence of Medicine, Pediatrics and Epidemiology at UCLA Schools of Medicine & Public Health, is to provide him with significant protected time to continue and expand his ongoing patient-oriented research with heightened focus on mentoring early-career investigators in several UCLA related campuses including Harbor-UCLA and Charles-Drew University. These centers provide care to underserved and indigent populations and minorities who suffer from CKD and who require dialysis to survive. African Americans and Hispanics are vastly overrepresented by 3.6 and 1.5 times greater than non-Hispanic Whites, respectively, among US dialysis patients. Whereas the 5-year survival of dialysis patients is <35%, with the highest mortality among malnourished patients, minorities exhibit lower dialysis mortality. Discovering the roots of CKD racial survival disparities and their link to nutritional status and dietary barriers can have major clinical and public health implications. PI hypothesizes that these disparities are due to distinct pathophysiologic mechanisms related to nutritional status and dietary intake across race; whereas 2 alternative hypotheses related to bone-and-mineral disorders and psychosocial and coping status will also be examined. PI proposes a 5-year patient-oriented, prospective study with repeated measures in a dynamic cohort of 1,050 hemodialysis (HD) patients (1/3 African Americans & 1/3 Hispanics), in collaboration with Southern California DaVita dialysis clinics. Nutritional status, dietary intake, psychosocial status & quality of life will be assessed longitudinally. Clinical events and survival will be followed, and specimens for ongoing and future ancillary studies will be stored. In a substudy of 360 subjects additional tests of body composition and dietary intake will be performed at GCRC. Race/ethnicity specific risk-stratification scores will be develop- ed and validated in a national retrospective cohort of over 100,000 HD patients. This K24 award with proposed cohort study will allow PI to achieve the following goals: (1) Continue and expand his productive activities and capabilities as a mentor and facilitator of training of new investigators in the fields of CKD nutrition & disparities by continuing his liaison with faculty across several campuses, schools and departments within UCLA system including Depts. of Medicine and Pediatrics, Charles-Drew Univ., and UCLA Public Health. (2) Continue and expand his credible efforts in increasing the availability of research participation to minority populations with CKD in Southern California; and (3) Continue to develop a relatively new area of CKD disparity and nutrition research specifically through continued support of the DaVita Clinical Research both in Southern California and across the nation by examining the cohort of Southern dialysis patients and national dialysis cohorts. The data collected and hypotheses generated throughout this 5-year cohort study will be utilized to power additional clinical studies by early career investigators and mentees under Dr. Kalantar to improve on patient care.

描述（由申请人提供）：这项中期研究者授予“营养不良，饮食和种族差异CKD中”的目的是由Kamyar Kalantar-Zadeh，医学博士，MPH，PHD，MPH，PHD，医学副教授，医学副教授，儿科和表育观者在医学和公共健康方面的延伸 - 在UCLA的研究中，与UCLA医学相关 - 在UCLA的范围内，与UCLA的研究相关 - 在UCLA中及时扩展，并在UCLA中及时延伸了时间，并在UCLA中延伸了时间，并在UCLA中延伸了时间，并在UCLA中及时延伸了时间，并在UCLA中延伸了时间，并为他提供了全面的影响。专注于在UCLA相关的几个校园中指导早期研究人员，包括Harbour-Ucla和Charles-Drew University。这些中心为遭受CKD且要求透析生存的贫困和贫困人口和少数群体提供护理。在美国透析患者中​​，非裔美国人和西班牙裔分别比非西班牙裔白人分别比非西班牙裔白人高3.6和1.5倍。透析患者的5年生存率<35％，营养不良的患者死亡率最高，但少数民族的透析死亡率较低。发现CKD种族生存差异的根源及其与营养状况和饮食障碍的联系可能具有重大的临床和公共卫生影响。 PI假设这些差异是由于与种族中的营养状况和饮食摄入有关的不同病理生理机制引起的。而2种与骨和矿物质疾病以及社会心理和应对状态有关的替代假设也将被检查。 PI提出了一项为期5年的注重患者的前瞻性研究，并在1,050个血液透析（HD）患者（1/3非洲裔美国人和1/3西班牙裔）的动态队列中进行了反复措施，并与南加州Davita Davita Diasis Clinics合作。营养状况，饮食摄入量，社会心理状况和生活质量将进行纵向评估。将遵循临床事件和生存，并将存储持续和未来辅助研究的标本。在360名受试者的物质中，将在GCRC上进行身体成分和饮食摄入的其他测试。种族/民族特定的风险分层分数将在全国回顾性的100,000多名高清患者中进行验证。通过拟议的队列研究，这项K24奖将使PI实现以下目标：（1）继续并扩大他在CKD营养和差异领域的新调查人员培训的指导者和促进者，通过继续与UCLA系统中的几个校园，学校和部门的教职员工进行联络，包括包括Depts在内的多个校园，学校和部门。医学和儿科，查尔斯·德鲁大学和加州大学洛杉矶分校的公共卫生。 （2）继续并扩大了他在加利福尼亚州CKD的少数族裔人口的可用性方面的可靠努力； （3）通过检查南加州和全国各地的Davita临床研究，通过研究南部透析患者和国家透析同伙的队列，继续开发相对较新的CKD差异和营养研究领域。在这项为期5年的队列研究中，收集的数据和假设将用于为Kalantar博士领导下的早期职业研究者和受训者提供额外的临床研究，以改善患者护理。