Identifying and Mitigating Risk Factors for Dehydration-Mediated Nephrolithiasis in Adolescents

 描述(由申请者提供)：K23以患者为导向的研究职业发展奖候选人旨在成为儿童肾结石研究的国际领导者，在使用创新干预措施提高治疗依从性和减少青少年肾结石复发方面具有特别的专业知识。拟议的有指导的研究和职业发展计划通过确定和减轻青少年脱水介导性肾结石的风险因素，促进了这一职业目标。环境温度过高和过低都会导致成年人脱水并增加患肾结石的风险，但温度对青少年结石风险的影响尚不清楚，他们特别容易受到极端温度的影响。水是减少肾结石发生的一种经济有效的方法；然而，尽管脱水在患有结石的青少年中很常见，但没有研究确定水的摄入障碍或开发干预措施来增加这一人群的水摄入量。目标1将确定青少年和成人中与肾结石表现相关的体温阈值的差异。目标2将使用通过移动设备收集的实时数据来确定肾结石青少年的饮水障碍。目的3将测量移动设备补水提醒对患有草酸钙肾结石的青少年尿草酸钙过饱和和尿量的即时和持续影响。应聘者带来了在一家大型城市儿童医院担任儿科泌尿外科医生的经验和临床流行病学方面的培训。在他的职业发展中，一个不可或缺的部分是与一个杰出的多学科指导团队保持关系。候选人的主要导师是苏珊·弗思医学博士。弗思博士是慢性肾脏疾病儿童治疗依从性方面的国际专家，在指导方面有着出色的记录。罗恩·科伦医学博士，公共卫生硕士，道格拉斯·维贝博士和珍妮特·奥德兰-麦戈文博士将分别在临床试验、青少年健康的生态瞬时评估和青少年健康的生物行为决定因素领域担任共同导师。一个咨询小组将帮助指导候选人的职业发展，并将提供代谢性肾结石疾病、青少年饮水、生物统计学以及使用手机游戏改善健康等方面的专业知识。拟议的研究和培训计划将扩大候选人在高级统计分析、临床试验和应用技术改善健康方面的专业知识，并将为候选人提供作为一名成功的独立研究人员职业生涯所需的技能和经验，专注于研究新的干预措施，以提高青少年的治疗依从性和减少肾结石复发。

 DESCRIPTION (provided by applicant): The candidate for this K23 Patient Oriented Research Career Development Award aims to become an international leader in pediatric nephrolithiasis research, with particular expertise in using innovative interventions to increase treatment adherence and decrease kidney stone recurrence among adolescents. The proposed mentored research and career development plan facilitates this career goal by identifying and mitigating risk factors for dehydration-mediated nephrolithiasis in adolescents. High and low ambient temperatures lead to dehydration and increase nephrolithiasis risk among adults, but the effect of temperature on stone risk in adolescents, who are particularly susceptible to temperature extremes, is unknown. Water is a cost-effective way to decrease kidney stone occurrence; however, despite dehydration being common among adolescents with stones, no studies have identified barriers to water intake or developed interventions to increase water intake in this population. Aim 1 will determine differences in the temperature thresholds associated with kidney stone presentation among adolescents and adults. Aim 2 will identify barriers to water intake among adolescents with kidney stones using real-time data gathered through mobile devices. Aim 3 will measure the immediate and sustained effect of mobile device hydration reminders on urine calcium oxalate supersaturation and urine volume in adolescents with calcium oxalate kidney stones. The candidate brings to this proposal experience as a pediatric urological surgeon at a large urban children's hospital and training in clinical epidemiology. An integral part of his career development will be continued relationship with an outstanding multidisciplinary mentoring team. The candidate's primary mentor is Susan Furth MD, PhD. Dr. Furth is an international expert in treatment adherence among children with chronic kidney disease and has an outstanding track-record of mentorship. Ron Keren MD, MPH, Douglas Wiebe PhD, and Janet Audrain-McGovern PhD, will serve as co-mentors in the areas of clinical trials, ecological momentary assessment of adolescent health, and biobehavioral determinants of adolescent health, respectively. An advisory panel will help guide the candidate's career development and will provide expertise in metabolic kidney stone disease, water access among adolescents, biostatistics, and using mobile games to improve health. The proposed research and training plan will expand the candidate's expertise in advanced statistical analysis, clinical trials, and applying technology to improve health, and will provide the candidate with the skills and experience necessary for a career as a successful independent researcher focused on investigating novel interventions to improve treatment adherence and decrease kidney stone recurrence among adolescents.