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: 8833278
• 负责人: DORRY L. SEGEV
• 金额: $ 18.5万
• 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/8833278
• 关键词: Address; Adult; Ancillary Study; Area; Award; Breathing; Clinical; Cognition; Cohort Studies; 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; 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; predictive modeling; professor; psychosocial; skills; success

DESCRIPTION (provided by applicant): 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

描述（由申请人提供）：美国有超过60万成年人患有ESRD。对于合适的患者，肾移植（KT）降低了死亡率，提高了生活质量，并节省了大量的医疗保险资金。然而，选择患者进行KT可能具有挑战性，特别是在某些亚组中，如老年人，目前的指标在告知临床决策方面的效用有限。此外，一旦被选中接受KT，患者在考虑已故捐赠者的提议或决定是否允许朋友或家人将自己置于活体捐赠者的风险中时面临类似的挑战。预测哪些患者将从KT中受益，并将其与合适的供体进行最佳匹配，是患者，移植医生和转诊肾病学家最关心的问题之一。这是约翰霍普金斯大学外科和流行病学副教授Dorry Segev，MD，PhD的K24中期职业研究者奖的提案。Segev博士领导了三项主要的R 01资助的以患者为导向的研究工作，以解决ESRD和KT临床决策的挑战：（1）老年透析患者和肾移植受者中虚弱和风险预测的前瞻性研究;（2）不相容活体供肾移植的长期结局和生存获益的回顾性研究;（3）肾脏捐献长期后遗症的多中心纵向研究。这些研究除了可达致个别赠款的目的外，亦为学员提供丰富的基础，供他们进行辅助研究，包括 成千上万的患者参与了几个队列，以及许多先进的方法学培训的机会。Segev博士积极指导学生，居民，研究员和初级教师在一个令人兴奋的，富有成效的多学科环境。这个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，实现以下新目标：（1）更好地了解对老年人重要的透析和KT结果;（2）量化不兼容KT方案的次要风险;（3）阐明肾脏捐赠后的家族性，遗传性和非肾脏风险;（4）了解肾脏捐赠后的肾脏风险。（4）设计模型，协助幼稚园候选人作出器官编配决定;和（5）通过接受指导方面的正式培训，从JHU的专家那里学习领导技能，继续促进整个机构的多学科合作，与来自全国各地的导师和学员建立联系，并完善向外科医生和其他临床医生教授以患者为导向的研究的课程