Nocturia and Chronic Medical illness

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DESCRIPTION (provided by applicant): This application outlines plans to further my personal education and mentoring of junior clinical researchers through support from a Mid-Career Award in Patient Oriented Research. A new direction in clinical research is also described, with specific emphasis on the interaction of diabetes with nocturia and other lower urinary tract symptoms (LUTS). Although not in itself life-threatening, nocturia can severely adversely affect patient quality of life and can be an indicator of poor overall health. Several lines of evidence suggest that chronic medical illnesses and medications used to treat those illnesses may affect the prevalence and severity of those nocturia and other LUTS. Healthcare providers attempting to relieve nocturia/LUTS are faced with a major knowledge gap related to the investigation and treatment of nocturia/LUTS in the setting of medical illness, as the magnitude of the effect of each illness and combined illnesses on those LUTS is unknown. This proposal seeks to formally study the relationship between glycemic control, renal function and LUTS in patients with and without diabetes. The results of this original research and informative epidemiological data will then be integrated to begin to form a model of the interaction of several chronic medical illnesses with nocturia/LUTS, and development of algorithms for the evaluation and treatment of patients with nocturia in that setting. The projects described will also be hypothesis-generating and will serve as vehicles for mentoring of current and future Fellows and Residents who choose to become interested in this line of research. The protected time afforded by the K24 award will also allow my continuing education in biostatistics, and my participation in the mentoring activities of the biostatistical consulting team. Further education in renal medicine in line with my proposed research project will also be feasible, with attendance at didactic sessions within the Mines VA medical center. Finally, salary support will allow me to continue and expand my mentoring efforts for the benefit of current and future colleagues, fellows and residents.