Prevalence and Impact of Frailty among Dialysis Patients

项目总结/摘要 我正在申请更新我的职业中期研究者奖以患者为导向的研究（K24），以 支持我的研究和指导工作。我完全致力于以病人为导向的研究和培训 肾脏病学研究的下一代研究人员。我开发了一个研究项目， 透析患者的功能，描述其局限性，研究病理生理学，并评估 干预措施，以改善功能。虽然我以前和目前资助的工作旨在评估脆弱性及其 在透析患者中，我相信身体功能和虚弱可能会增加重要的 信息以告知CKD谱中沿着的其他点的临床护理。特别是，我计划扩大我的 重点关注从非透析CKD到ESRD以及从透析到移植的护理过渡。 目的是在一个国家中检查CKD期间的功能状态与ESRD期间的结局之间的关系。 一组退伍军人，并测量一组肾移植候选人的身体表现， 确定移植后结果与身体表现和虚弱的相关程度， 移植前评估我有一个强大的辅导记录，我在一个丰富的，支持的， 在加州大学旧金山分校和肾脏科的大学环境。K24的持续资助将使我能够 我将继续把更多的时间放在研究和指导上，而不是临床和行政工作上。

PROJECT SUMMARY/ABSTRACT I am applying to renew my Mid-career Investigator Award in Patient Oriented Research (K24) in order to support my research and mentoring efforts. I am fully committed to patient oriented research and to training the next generation of researchers in nephrology research. I have developed a research program studying physical functioning in patients on dialysis, characterizing their limitations, studying the pathophysiology, and evaluating interventions to improve functioning. While my previous and currently funded work aims to assess frailty and its evolution among patients on dialysis, I am convinced that physical function and frailty could add important information to inform clinical care at other points along the spectrum of CKD. In particular, I plan to expand my focus to the transitions of care from non-dialysis requiring CKD to ESRD and from dialysis to transplantation. Aims are to examine associations of functional status during CKD with outcomes during ESRD in a national cohort of veterans and to measure physical performance in a cohort of kidney transplant candidates to determine the extent to which post-transplant outcomes are related to physical performance and frailty during pre-transplant evaluation. I have a strong track record of mentoring, and I work within a rich, supportive, and collegial environment at UCSF and in the Division of Nephrology. Continued K24 funding will permit me to continue to focus more of my time on research and mentoring and less on clinical and administrative work.