Patient Oriented Research in Kidney Disease and Transplant Surgery

以患者为中心的肾脏疾病和移植手术研究

• 批准号: 8679374
• 负责人: DORRY L. SEGEV
• 金额: $ 18.56万
• 依托单位: JOHNS HOPKINS UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2014
• 资助国家: 美国
• 起止时间: 2014-04-15 至 2019-03-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8679374
• 关键词: Address; Adult; Ancillary Study; Area; Award; Breathing; Clinical; Cognition; Cohort Studies; Commit; Country; Creatinine; Data; Development; Dialysis patients; Dialysis procedure; Doctor of Philosophy; Educational Curriculum; Educational process of instructing; Elderly; End stage renal failure; Environment; Epidemiology; Face; Faculty; Family; Fellowship; Fostering; Friends; Funding; Future; Gender; Genotype; Grant; Health; Hospitalization; Immunosuppression; Individual; Infection; Institution; Interdisciplinary Study; Ischemia; Journals; K-Series Research Career Programs; Kidney; Kidney Diseases; Kidney Transplantation; Leadership; Learning; Living Donors; Longitudinal Studies; Measures; Medicare; Mentors; Mentorship; Methods; Metric; Modeling; Operative Surgical Procedures; Organ; Outcome; Paper; Patients; Physicians; Pilot Projects; Process; Prospective Studies; Protocols documentation; Publishing; Quality of life; Recording of previous events; Recurrence; Research; Research Personnel; Retrospective Studies; Right kidney; Risk; Scientist; Structure; Students; Subgroup; Surgeon; Time; Training; Transplant Recipients; Transplantation; Universities; Work; career development; clinical decision-making; cohort; cost; experience; frailty; improved; model design; mortality; multidisciplinary; next generation; non-genetic; patient oriented; patient oriented research; professor; psychosocial; skills; success

Summary Over 600,000 adults in the US suffer from ESRD. For the appropriate patients, kidney transplantation (KT) reduces mortality, improves quality of life, and saves substantial Medicare dollars. However, selecting patients for KT can be challenging, particularly among certain subgroups such as older adults, and current metrics are of limited utility in informing clinical decision-making. Furthermore, once selected for KT, patients face similar challenges when considering deceased donor offers or deciding if to allow friends or family to put themselves at risk as living donors. Predicting which patients would benefit from KT, and optimally matching them to the right donor, is one of the most critical concerns for patients, transplant physicians, and referring nephrologists. This is a proposal for a K24 Midcareer Investigator Award for Dorry Segev, MD, PhD, an Associate Professor of Surgery and Epidemiology at Johns Hopkins University. Dr. Segev leads three major R01-funded patient- oriented research efforts to address the challenges of ESRD and KT clinical decision-making: (1) A prospective study of frailty and risk prediction among older dialysis patients and kidney transplant recipients; (2) A retrospective study of long-term outcomes and survival benefit from incompatible live donor kidney transplantation; and (3) A multi-center longitudinal study of long-term sequelae of kidney donation. In addition to addressing the aims of the individual grants, these studies provide rich substrate for ancillary studies by mentees, including thousands of patients engaged in several cohorts, as well as many opportunities for advanced methodologic training. Dr. Segev is actively mentoring students, residents, fellows, and junior faculty in an exciting, productive multidisciplinary environment. This K24 will afford future mentees the opportunity to leverage Dr. Segev's rich ongoing research portfolio with the following new aims: (1) To better understand dialysis and KT outcomes important to older adults; (2) To quantify secondary risks of incompatible KT protocols; (3) To elucidate familial, genetic, and non-renal risks after kidney donation; (4) To design models to assist KT candidates with organ offer decisions; and (5) To expand Dr. Segev's capacity to mentor the next generation of clinician-scientists in ESRD and KT by pursuing formal training in mentoring, learning leadership skills from experts at JHU, continuing to foster multidisciplinary collaborations across the institution, connecting with mentors and mentees from across the country, and refining a curriculum for teaching patient-oriented research to surgeons and other clinicians

摘要 在美国，超过60万成年人患有ESRD。对于合适的患者，肾移植(KT) 降低死亡率，提高生活质量，并节省大量的医疗保险费用。然而，选择患者 对于KT来说，可能是具有挑战性的，特别是在某些子组中，如老年人，而当前的指标是 在为临床决策提供信息方面的效用有限。此外，一旦被选中接受KT，患者将面临类似的 考虑已故捐赠者的提议或决定是否允许朋友或家人 作为活着的捐赠者处于危险之中。预测哪些患者将从KT中受益，并将他们与 正确的供者，是患者、移植医生和推荐的肾科医生最关心的问题之一。 这是为副教授Dorry Segev，医学博士，博士颁发的K24职业中期研究人员奖的建议 约翰斯·霍普金斯大学外科和流行病学教授。塞格夫博士领导着三个主要的R01资助患者- 应对ESRD和KT临床决策挑战的定向研究努力：(1)前瞻性 老年透析患者和肾移植受者的脆弱性及风险预测研究；(2) 供肾血型不合的远期结局和生存收益的回顾性研究 (3)肾移植远期后遗症的多中心纵向研究。此外 为了达到个人资助的目的，这些研究为辅助研究提供了丰富的基础，包括 指导对象，包括参与几个队列的数千名患者，以及许多机会 高级方法论培训。赛格夫博士积极指导学生、住院医生、研究员和初级教员 在一个令人兴奋的、富有成效的多学科环境中。 这款K24将为未来的学员提供机会，利用Segev博士丰富的正在进行的研究组合 以下新目标：(1)更好地了解透析和KT结果对老年人的重要性；(2) 量化不相容KT方案的次要风险；(3)阐明家族性、遗传性和非肾脏风险 捐献肾脏后；(4)设计模型以协助KT候选人作出器官捐献决定；及(5) 扩大Segev博士的能力，通过以下方式指导ESRD和KT的下一代临床医生-科学家 正规的指导培训，从JHU的专家那里学习领导技能，继续培养多学科 整个机构的协作，与来自全国各地的导师和学员联系，以及 完善课程，向外科医生和其他临床医生讲授以病人为中心的研究