Role of pre-ESRD blood pressure management on post-ESRD outcomes

ESRD 前血压管理对 ESRD 后结局的作用

• 批准号: 8715515
• 负责人: Elaine Ku
• 金额: $ 5.61万
• 依托单位: UNIVERSITY OF CALIFORNIA, SAN FRANCISCO
• 依托单位国家: 美国
• 财政年份: 2014
• 资助国家: 美国
• 起止时间: 2014-12-01 至 2015-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8715515
• 关键词: Affect; African American; Antihypertensive Agents; Blood Pressure; California; Caring; Chronic Kidney Failure; Clinical Research; Clinical Trials; Data; Diet Modification; Disease; Disease Outcome; End stage renal failure; Enrollment; Event; Funding; Future; Goals; Hospitalization; Hypertension; Intervention; Kidney Diseases; Link; Master' s Degree; Morbidity - disease rate; Nutrition management; Onset of illness; Outcome; Outcome Study; Participant; Patients; Phase; Randomized; Randomized Controlled Trials; Registries; Research; Research Design; Risk; Risk Factors; Role; San Francisco; System; Therapeutic; Training; United States; United States National Institutes of Health; Universities; Work; adverse outcome; blood pressure regulation; disease registry; disorder risk; high risk; insight; modifiable risk; mortality; non-diabetic; programs; prospective; protein intake; public health relevance

DESCRIPTION (provided by applicant): Although chronic kidney disease (CKD) is the precursor to end-stage renal disease (ESRD), few studies of outcomes after ESRD have captured information about events that occurred during CKD. Basic and important questions therefore remain unanswered. For example, how do interventions during the CKD phase of disease affect outcomes at the ESRD phase of disease? The major goal in this study is to understand whether and how mortality risk among ESRD patients is affected by tightness of blood pressure control during CKD. To achieve this, we will study enrollees of two completed NIH-sponsored randomized controlled trials: the Modification of Diet in Renal Disease (MDRD) study and the African American Study of Kidney Disease and Hypertension (AASK). Both MDRD and AASK enrolled patients during the CKD phase of disease, but numerous participants went on to develop ESRD and their post- ESRD outcomes can be tracked via United States Renal Disease System (USRDS), the nationally comprehensive ESRD registry. Our research approach and study design lends opportunities to examine how other therapeutic choices during the CKD phase of disease will affect outcomes after ESRD. By linking USRDS with MDRD and AASK, we will gain new insight into modifiable risk factors contributing to the high rates of adverse outcomes among patients with ESRD. Our results may inform the debate about how tightly blood pressure should be managed among CKD patients as well as guide nutrition management and other aspects of care in kidney disease patients.

描述（由申请人提供）：尽管慢性肾脏疾病（CKD）是终末期肾脏疾病（ESRD）的前兆，但很少有关于ESRD后结局的研究获得了关于CKD期间发生的事件的信息。因此，基本和重要的问题仍然没有答案。例如，CKD阶段的干预措施如何影响ESRD阶段的结局？本研究的主要目的是了解CKD期间血压控制的严密性是否以及如何影响ESRD患者的死亡风险。为了实现这一目标，我们将研究两项已完成的NIH申办的随机对照试验的入组者：肾脏疾病饮食改良（MDRD）研究和非裔美国人肾脏疾病和高血压研究（AASK）。MDRD和AASK均招募了CKD疾病阶段的患者，但许多参与者继续发展为ESRD，其ESRD后结局可通过美国肾脏疾病系统（USRDS）进行跟踪，USRDS是全国综合性ESRD登记研究。我们的研究方法和研究设计提供了机会，以检查在疾病的CKD阶段的其他治疗选择将如何影响ESRD后的结果。通过将USRDS与MDRD和AASK联系起来，我们将对导致ESRD患者不良结局发生率高的可改变风险因素有新的认识。我们的研究结果可能会为关于CKD患者血压管理的严格程度的辩论提供信息，并指导肾脏疾病患者的营养管理和其他方面的护理。