Cognitive Impairment in End Stage Renal Disease

终末期肾病的认知障碍

基本信息

批准号：
10599660
负责人：
Aditi Gupta
金额：
$ 19.22万
依托单位：
UNIVERSITY OF KANSAS MEDICAL CENTER
依托单位国家：
美国
项目类别：
财政年份：
2017
资助国家：
美国
起止时间：
2017-08-01 至 2023-04-30
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/10599660
关键词：
Affect Age Aging Alzheimer&apos s Disease Area Biometry Boston Brain Brain Injuries Brain imaging Burn injury Cerebrovascular Circulation Cerebrum Chronic Kidney Failure Clinical Management Clinical Research Cognition Cognitive Cognitive deficits Data Dialysis procedure Doctor of Medicine Elderly End stage renal failure Environment Evaluation Exercise Future Goals Health Health Care Costs Hippocampus (Brain)Image Impaired cognition Impairment Injury Institution K-Series Research Career Programs Kansas Kidney Kidney Transplantation Knowledge Lead Lesion Link Longitudinal Studies Measures Mediating Medical center Memory Mentored Patient-Oriented Research Career Development Award Mentors Metabolic Methods Morbidity - disease rate Nephrology Neurology Neuropsychology Outcome Patient Education Patients Positioning Attribute Procedures Psychology Quality of life Renal clearance function Renal function Research Research Design Research Personnel Resources Role Short-Term Memory Structure Techniques Therapeutic Toxin Training Transplant Recipients Transplantation United States Universities Wait Time Well in self Work biomedical imaging brain health brain magnetic resonance imaging brain metabolism cerebral atrophy cognitive function executive function experience imaging facilities improved improved functioning insight novel older patient patient oriented post-transplant prevent preventive intervention white matter

项目摘要

PROJECT SUMMARY Cognitive impairment affects the majority of older adults with end stage renal disease (ESRD) and negatively impacts their quality of life, health care costs, and health outcomes. Our long-term goal is to develop strategies to prevent and treat cognitive impairment in patients with ESRD. Our preliminary data indicate that specific domains of cognition improve with kidney transplantation, with corresponding changes in brain structure. These data indicate potential reversibility in both cognitive impairment and structural brain changes associated with ESRD. In this proposal, we will longitudinally study patients with ESRD before and after kidney transplantation. By comparing baseline cognition and brain MRI findings between ESRD patients and controls, we will more firmly define the domains of cognition that are affected in ESRD, and whether cognitive impairment associated with ESRD corresponds to structural changes in the brain. By comparing cognitive function and brain changes before and after kidney transplantation, we will determine the extent of reversibility in cognition and in accompanying structural changes in the brain that may functionally regulate the improvements in cognition. The proposed research will pinpoint areas of reversibility in cognitive function and brain structural changes in ESRD and identify targets for future therapies. Data from this study will also identify cognitive deficits in both pre- and post- transplant patients with ESRD. This information will have implications in the clinical management of patients with ESRD and the methods used for patient education. This Mentored Patient-Oriented Career Development Award (K23) will provide the PI with the necessary training and expertise in cognitive function assessment, brain imaging, and clinical research through didactic and hands on courses, mentoring, and applied experiences. The PI is a transplant nephrologist who has collaborated with Jeffrey Burns, M.D., the Co-Director of University of Kansas Alzheimer's Disease Center; William Brooks, Ph.D, the Director of the Hoglund Brain Imaging Center, David Johnson, Ph.D, the Director of Neuropsychology at the University of Kansas Alzheimer's Disease Center and Mark Sarnak, M.D., an acclaimed investigator in cognitive impairment in ESRD at the Tufts Medical Center, Boston, MA. This unique combination of expertise makes our group ideal for this study.

项目摘要认知障碍会影响大多数终阶段肾脏疾病（ESRD）的老年人，并且负面影响影响他们的生活质量，医疗保健成本和健康成果。我们的长期目标是制定策略为了预防和治疗ESRD患者的认知障碍。我们的初步数据表明特定于认知领域随肾移植而改善，随着大脑结构的相应变化。这些数据表明认知障碍和与结构性大脑变化相关的潜在可逆性与ESRD。在此提案中，我们将在肾脏前后纵向研究ESRD的患者移植。通过比较ESRD患者与对照组之间的基线认知和脑MRI发现，我们将更牢固地定义ESRD中受影响的认知领域，以及是否认知与ESRD相关的损伤对应于大脑的结构变化。通过比较认知肾移植前后的功能和大脑会发生变化，我们将确定可逆性的程度在认知和伴随的大脑结构变化中，可能在功能上调节认知的改善。拟议的研究将指出认知功能中可逆性的领域和 ESRD的大脑结构变化并确定未来疗法的靶标。这项研究的数据还将确定 ESRD前和移植后患者的认知缺陷。这些信息将在 ESRD患者的临床管理以及用于患者教育的方法。这是指导的面向患者的职业发展奖（K23）将为PI提供必要的培训和通过教学和动手进行认知功能评估，大脑成像和临床研究方面的专业知识课程，指导和应用经验。 PI是一名移植肾脏科医生，与堪萨斯大学阿尔茨海默氏病中心联合主任杰弗里·伯恩斯（Jeffrey Burns），医学博士；威廉·布鲁克斯（William Brooks），霍格伦德脑成像中心主任博士，戴维·约翰逊（David Johnson）博士堪萨斯大学阿尔茨海默氏病中心的神经心理学和医学博士马克·萨尔纳克（Mark Sarnak）马萨诸塞州波士顿塔夫茨医学中心的ESRD认知障碍的备受赞誉的调查员。这个独特专业知识的结合使我们的小组理想这项研究。