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: 9064768
• 负责人: DORRY L. SEGEV
• 金额: $ 18.43万
• 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/9064768
• 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; 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; Subgroup; Surgeon; Time; Training; Transplant Recipients; Transplantation; Universities; Work; career development; clinical decision-making; cohort; cost; experience; frailty; gender disparity; improved; mid-career faculty; model design; mortality; multidisciplinary; next generation; non-genetic; patient oriented; patient oriented research; predictive modeling; psychosocial; skills; student mentoring; success; survival outcome

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60万名成年人患有ESRD。对于适当的患者，肾脏移植（KT）降低了死亡率，改善了生活质量并节省了大量的Medicare美元。但是，选择KT患者可能具有挑战性，尤其是在某些亚组（例如老年人）中，目前的指标在为临床决策提供信息方面的效用有限。此外，一旦被选为KT，患者在考虑已故捐赠者的要约或决定是否允许朋友或家人将自己处于危险中时面临类似的挑战。预测哪些患者将从KT中受益，并将他们与合适的捐助者最佳相匹配，这是患者，移植医师和参考肾脏病医生的最关键问题之一。这是约翰·霍普金斯大学（Johns Hopkins University）手术与流行病学副教授，曾获得K24中级护理研究员奖K24中级研究员奖。 Segev博士领导了三个主要的R01资助的由患者的研究工作，以应对ESRD和KT临床决策的挑战：（1）对老年透析患者和肾脏移植受者的脆弱和风险预测的前瞻性研究； （2）对不兼容的活供体肾移植的长期结局和生存益处的回顾性研究； （3）肾脏捐赠的长期后遗症的多中心纵向研究。除了解决各个赠款的目标外，这些研究还为受训者提供了丰富的辅助研究底物，包括 成千上万的患者参与了几个队列，以及许多高级方法论培训的机会。 Segev博士正在积极指导学生，居民，研究员和初级教师，以令人兴奋的富有生产力的多学科环境。这款K24将为未来的受训者提供利用Segev博士的丰富研究组合的机会，并具有以下新目标：（1）更好地了解对老年人重要的透析和KT结果； （2）量化不兼容的KT协议的次要风险； （3）在肾脏捐赠后阐明家族性，遗传和非肾脏风险； （4）设计模型以协助KT候选人进行器官提供决定； （5）通过在JHU的专家中学习领导力的正式培训，继续在机构中培养多学科合作，以与全国各地的导师联系，并在整个国家的训练中与其他研究人员建立联系，并与其他研究人员联系，并与其他研究人员联系，并促进了研究患者的研究人员，从而扩大了Segev博士在ESRD和KT中指导下一代临床医生在ESRD和KT中指导下一代临床医生的能力的能力（5）