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）可以降低死亡率，提高生活质量，并节省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，一旦选择了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冒着风险作为活体捐赠者时，也面临着类似的挑战。预测哪些患者将受益于KT，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。这是一份K24职业中期研究者奖的提案，授予约翰霍普金斯大学外科和流行病学副教授Dorry Segev。Segev博士领导三项主要的r01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的脆弱性和风险预测的前瞻性研究；(2)不相容活体肾移植的长期预后和生存获益回顾性研究；(3)肾脏捐献长期后遗症的多中心纵向研究。除了解决个人资助的目的外，这些研究还为学员的辅助研究提供了丰富的基础，包括