Improving Kidney Health Assessment in Young Patients with Spina Bifida

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PROJECT SUMMARY This Career Development Award will help David I. Chu, MD, MSCE, become an independent surgeon-scientist who will develop the evidence to improve kidney, bladder, and overall health in young patients with spina bifida. Dr. Chu will use this award to build on his existing foundation in clinical epidemiology to achieve five career development goals: 1) Develop expertise in patient-oriented research (POR); 2) Acquire experience in qualitative research; 3) Gain knowledge in creating and implementing consensus strategies; 4) Strengthen research portfolio and grantsmanship skills; and 5) Build inter-disciplinary, multi-institutional research collaborations. These skills will allow him to translate research into clinical practice to improve outcomes in patients with spina bifida. Dr. Chu will achieve these career objectives through a career development plan that consists of intensive experiential training, structured didactics and workshops, and a comprehensive mentoring program. His Primary Mentor is Dr. Tamara Isakova, an expert in POR in chronic kidney disease with an outstanding record of extramural funding and mentorship. His Co-Mentor is Dr. Earl Cheng, a national leader in pediatric urologic reconstructive surgery and spina bifida care. His Advisory Committee includes interdisciplinary experts in kidney function equations (Dr. Susan Furth, MD, PhD), qualitative research (Dr. Elisa Gordon, PhD, MPH), consensus-building and implementation in surgery (Dr. Mehul Raval, MD, MS), and advanced implementation science methodology (Dr. Justin Smith, PhD). Dr. Chu’s career development plan will be supported by the exceptional institutional environment of Lurie Children’s Hospital and Northwestern University, including the 1) Dedicated resources and research infrastructure within Lurie Children’s Hospital’s Division of Urology and Department of Surgery; 2) Robust, high-volume, and multi-disciplinary Lurie Children’s Hospital Spina Bifida Clinic; and 3) Strong research support from Northwestern University’s Clinical and Translation Sciences Institute and the Institute for Public Health and Medicine. The overall objective of this scientific proposal is to improve kidney health assessment tools and approaches in young patients with spina bifida. Various guidelines prioritize preserving kidney health in these patients, but preliminary evidence suggests that current tools and approaches for assessing kidney health are inaccurate, not patient-centered, and not uniformly implemented by providers. The Aims of this proposal are to: 1) Compare current kidney function estimating equations to gold-standard iohexol plasma clearance tests and develop novel, spina-bifida- specific equations; 2) Assess patient knowledge, attitudes, and beliefs towards kidney health and evaluation, guided by the revised Health Belief Model; and 3) Assess provider preferences, barriers, and facilitators towards kidney health surveillance methods and strategies to create consensus implementation practices. The combination of advanced quantitative, qualitative, and implementation research methods and mentored training will ensure Dr. Chu emerges as a highly successful, independent investigator in spina bifida care.