A Mentoring Program in Kidney Care for Older Adults

项目摘要/摘要 这项关于以患者为中心的研究的职业生涯中期奖的提议(K24)将 支持斯坦福大学肾病学家Manjula Kurella Tamura博士的研究计划 大学和退伍军人事务主任帕洛阿尔托老年医学研究和教育 临床中心。候选人领导着一个多学科的研究计划，重点是 老年人透析治疗的以患者为中心的结果。她的研究项目， 由保健服务部分和干预部分组成， 在过去的五年中得到了五个联邦资助的奖项的支持，并产生了一个 广泛的工作组合，以支持假设驱动的导师研究。在此期间， 候选人的研究计划为13名初级调查人员提供了培训机会 成功地获得了资金，在高影响力的期刊上发表了研究成果，并过渡到 变成了学术职位。在这个K24应用程序中，她的首要目标是发展和保持这一点 计划方式：(1)通过接受关键领域的培训，提高她作为研究导师的技能， (2)将她的研究作为一个平台，指导来自一系列学科的受训者，以及(3) 将她的研究扩展到评估肾脏疾病病程早期的治疗权衡。 最近的临床试验表明，与标准血压目标相比，强化血压目标可以降低 死亡率和心血管事件，但以肾功能为代价。的科学目标 此应用程序用于评估集约型与标准型的危害和收益的比较 高血压治疗和高血压停药在两个现实世界中对肾终点的影响 年长的成年人队列。第二个目标是演示新的分析方法的应用 将因果效应从随机试验扩展到年龄较大和病情较重人群的方法。 候选人的指导计划将整合培训领域的资源 斯坦福大学和弗吉尼亚州帕洛阿尔托大学的课程，为职业生涯量身定做的独特机会 科学家在衰老研究方面的进展。

PROJECT SUMMARY/ABSTRACT This proposal for a Midcareer Investigator Award in Patient-Oriented Research (K24) will support the research program of Dr. Manjula Kurella Tamura, a nephrologist at Stanford University and Director of the Veterans Affairs Palo Alto Geriatric Research and Education Clinical Center. The candidate leads a multi-disciplinary research program which is focused on patient-centered outcomes of dialysis treatment in older adults. Her research program, comprised of a health services component and an interventions component, has been supported by five federally funded awards during the past five years, and has produced an extensive portfolio of work to support hypothesis driven mentee research. During this time, the candidate’s research program has provided training opportunities for 13 junior investigators who have successfully obtained funding, published research in high-impact journals, and transitioned into academic positions. In this K24 application, her overarching goal is to grow and sustain this program by: (1) enhancing her skills as a research mentor by obtaining training in key areas, and (2) using her research as a platform to mentor trainees from a range of disciplines, and (3) extending her research to evaluate treatment trade-offs earlier in the course of kidney disease. Recent clinical trials demonstrate that intensive versus standard blood pressure targets reduce mortality and cardiovascular events, but at the expense of kidney function. The scientific goal of this application is to evaluate the comparative harms and benefits of intensive versus standard hypertension treatment and hypertension deprescribing on kidney end-points in two real world older adult cohorts. The secondary goal is to demonstrate the application of novel analytical approaches that extend causal effects from randomized trials to older and sicker populations. The candidate’s mentoring program will integrate resources from the breadth of training programs at Stanford and VA Palo Alto, with unique opportunities tailored to the career development of scientists in aging research.