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Feasibility of obtaining measured glomerular filtration rate among young adults with cerebral palsy

获得脑瘫青壮年肾小球滤过率测定值的可行性

基本信息

批准号：
10265670
负责人：
Daniel Whitney
金额：
$ 7.8万
依托单位：
UNIVERSITY OF MICHIGAN AT ANN ARBOR
依托单位国家：
美国
项目类别：
财政年份：
2021
资助国家：
美国
起止时间：
2021-08-06 至 2023-07-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/10265670
关键词：
Address Adopted Adult Age Age-Years Aging Agreement Body fat Cardiovascular system Cerebral Palsy Cessation of life Child Childhood Chronic Kidney Failure Classification Clinic Clinical Clinical Protocols Clinical assessments Complex Consent Creatinine Development Disease Disease Progression Early Intervention Enrollment Equation Etiology Exercise Fatty acid glycerol esters Foundations Future Glomerular Filtration Rate Goals Gold Health Healthcare Incidence Individual Intervention Interview Iothalamate Kidney Kidney Diseases Knowledge Lead Longevity Measurement Measures Methods Mission Monitor Morbidity - disease rate Motor Muscle National Institute of Child Health and Human Development Outcome Participant Patients Pentetic Acid Personal Satisfaction Population Predisposition Premature Birth Procedures Protocols documentation Public Health Race Renal function Research Risk Serum Severities System Technical Expertise Testing Treatment Efficacy Vulnerable Populations Work acceptability and feasibility blood pressure regulation burden of illness clinical practice cost disability epidemiology study experience improved innovation kidney dysfunction method development mortality motor disorder multidisciplinary multiple chronic conditions novel post gamma-globulins premature prevent recruit research clinical testing research study societal costs standard measure therapy development young adult young man young woman

项目摘要

PROJECT SUMMARY Young adults 18-40 years of age with cerebral palsy (CP) have unmet healthcare needs and heightened susceptibility for kidney disease, which may result in greater risk for premature morbidity and mortality; however, little is known about kidney function for individuals with CP. This is due to misinterpretation of clinical measures of kidney function that are not appropriate for CP, leading to inaccurate assessment of kidney function. Interventions at earlier stages of kidney dysfunction can be highly effective at mitigating long-term risk of kidney disease; however, intervention efforts are hindered without accurate assessments of glomerular filtration rate (GFR), the clinical gold-standard measure of kidney function, in patients with CP. No studies have measured GFR (mGFR) for CP. The feasibility of obtaining mGFR in adults with CP is unknown, as is the accuracy of estimating GFR (eGFR) using traditional equations through non-invasive methods. There may be specific barriers in mGFR testing for adults with CP. Therefore, identifying clinical feasibility and reasonable accommodations to accurately assess mGFR is a vital first step. The long-term goal is to understand, prevent, and treat kidney dysfunction to improve healthful aging for individuals with CP. The objective of this study is to lay the foundation for future research and clinical intervention by determining the clinical feasibility of obtaining mGFR using the widely adopted clinical test, 125I-Iothalamate, and the 99mTc-DTPA test, which is a less- involved clinical protocol, for young adults 18-40 years old with CP. Specifically, the primary Aim of this study will measure the proportion of those consented to those approached, proportion of those completing testing procedures to those consented, acceptability of testing using validated measures, and exit interviews that probe barriers and facilitators to enrollment and testing challenges for both the participants with CP and the experienced technicians obtaining mGFR. The exit interviews will allow us to identify and develop reasonable accommodations to enhance recruitment and completion of testing for future research studies and to inform clinical practice. If both clinical protocols prove reliable mGFR measures as determined by routine clinical standards, we will explore: (1) the agreement between tests, which will provide evidence of which test can be used for research and clinic; and (2) the degree of discrepancy between mGFR and eGFR by severity of CP. This information will initiate needed work in providing a clinically-friendly CP correction factor or a CP-specific equation for eGFR to improve clinical monitoring of kidney function for this vulnerable population. The research is innovative because it will challenge the current status quo that kidney function is normal for CP, which is due to misinterpretation of kidney function from routinely used clinical measures that are not appropriate for CP rather than true kidney function. The research is significant because accurate assessment of kidney function for CP is necessary for clinical interventions to prevent the onset and delay the progression of kidney disease.