Frequency domain shortwave infrared spectroscopy (FD-SWIRS) for volume status monitoring during hemodialysis in end stage kidney disease

频域短波红外光谱 (FD-SWIRS) 用于终末期肾病血液透析期间容量状态监测

• 批准号: 10580084
• 负责人: Vipul C Chitalia
• 金额: $ 25.41万
• 依托单位: BOSTON UNIVERSITY (CHARLES RIVER CAMPUS)
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-03-01 至 2025-01-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10580084
• 关键词: Academic Medical Centers; Address; American; Area; Astronomy; Benchmarking; Binding; Blood; Body Weight Changes; Boston; Cardiovascular system; Cause of Death; Chronic Kidney Failure; Clinical; Clinical Research; Collaborations; Country; Data; Dialysis procedure; Diffuse; Dryness; Edema; End stage renal failure; Excision; Fat emulsion; Fatigue; Feasibility Studies; Fluid overload; Frequencies; Funding; Health; Healthcare; Heart failure; Hemodialysis; Homeostasis; Hour; Hypertension; Hypotension; Kidney; Kidney Transplantation; Label; Lateral; Leg; Lighting; Lipids; Liquid substance; Location; Measurement; Methods; Modeling; Monitor; Muscle Cramp; Nausea; Nephrology; Optics; Pain; Patients; Performance; Phase; Physicians; Pilot Projects; Population; Process; Property; Proteins; Quality of life; Renal function; Research Priority; Scientist; Short Waves; Signal Transduction; Source; Spectrum Analysis; Speed; Symptoms; System; Techniques; Technology; Testing; Time; Tissues; Titrations; Toxin; Ultrafiltration; Variant; Vomiting; Water; Weight; absorption; care burden; digital; experimental study; extracellular; healthy volunteer; indexing; infrared spectroscopy; mortality; new technology; novel; premature; prevent; solute; standard of care

PROJECT SUMMARY Chronic kidney disease (CKD), or the gradual loss of kidney function, is the ninth leading cause of death in the US and poses an astronomical healthcare burden. CKD eventually leads to end-stage kidney disease (ESKD), requiring hemodialysis treatment (HD) or kidney transplant for survival. HD is the process of removing excess water, solutes, and toxins from the blood in patients, as kidneys can no longer perform these natural functions. In 2017 there were 746,557 Americans with ESKD, and 70% of these were on HD. Patients with ESKD accumulate fluid in between HD sessions, whose removal is a quintessential function of HD. Insufficient fluid removal on HD results in volume overload contributing to hypertension, heart failure and eventual cardiovascular mortality. Excess fluid removal results in hypotension, muscle cramps and compromises vitality after HD. Thus, it is critical to maintain dry weight, or weight without excess fluid in CKD patients. Despite the central importance of maintaining volume homeostasis in patients with ESKD, there are currently no quantitative standards for monitoring volume status of patients undergoing HD. The volume assessment of patients on HD remains the most challenging aspect of nephrology practice. This project aims to develop frequency-domain shortwave infrared spectroscopy (FD-SWIRS) for the unmet clinical need of HD volume status monitoring in patients with ESKD. The SWIR wavelength band (also called NIR II) is more sensitive to water and lipids compared to the visible or NIR bands, and can potentially provide deeper tissue measurements. FD-SWIRS will provide measurements of the absolute absorption and reduced scattering coefficients over a broad wavelength range (900-1310 nm). FD-SWIRS would represent a new technology, and to the best of our knowledge, no similar technologies have been used for HD monitoring. FD-SWIRS will provide three unique sources of label-free contrast for HD monitoring: 1) tissue molar water concentration changes calculated from broadband (900-1310 nm) absorption coefficients (µa), 2) broadband reduced scattering (µs′), and 3) bound water index (BWI), which utilizes subtle spectral shifts related to the binding of water molecules to proteins in tissue. We hypothesize that that these sources of contrast will accurately reveal volume status and provide a non-invasive indicator of extracellular versus intracellular water, which has been shown to be important for volume assessment. We will first develop an FD-SWIRS system and validate performance through rigorous system testing. A multi-layer inverse model will be developed to extract deep tissue optical properties. We will then perform pre, post and intradialytic measurements of FD-SWIRS in 50 dialysis sessions with the hypothesis that there will be alteration in FD-SWIRS signal between pre and post-HD time points. In addition, we posit that FD-SWIRS signal will change throughout dialysis session and may coincide or precede the dialysis-related complications. Successful completion of this pilot project will be the first to apply a novel technique FD-SWIRS to an important clinical problem in patients on HD, and will guide subsequent R01-scale funding.

项目总结

项目成果

Inactivation of Minar2 in mice hyperactivates mTOR signaling and results in obesity.

• DOI: 10.1016/j.molmet.2023.101744
• 发表时间: 2023-07
• 期刊: MOLECULAR METABOLISM
• 影响因子: 8.1
• 作者: Lotfollahzadeh, Saran;Xia, Chaoshuang;Amraei, Razie;Hua, Ning;Kandror, Konstantin V.;Farmer, Stephen R.;Wei, Wenyi;Costello, Catherine E.;Chitalia, Vipul;Rahimi, Nader
• 通讯作者: Rahimi, Nader

Epidemiology of Cancer-Associated Venous Thromboembolism in Patients With Solid and Hematologic Neoplasms in the Veterans Affairs Health Care System.

• DOI: 10.1001/jamanetworkopen.2023.17945
• 发表时间: 2023-06-01
• 期刊: JAMA network open
• 影响因子: 13.8

Venous thromboembolism risk in cancer patients receiving first-line immune checkpoint inhibitor versus chemotherapy.

接受一线免疫检查点抑制剂与化疗的癌症患者的静脉血栓栓塞风险。

• DOI: 10.1002/ajh.26954
• 发表时间: 2023
• 期刊: American journal of hematology
• 影响因子: 12.8
• 作者: Li,Ang;May,SarahB;La,Jennifer;Martens,KyleeL;Amos,ChristopherI;Flowers,ChristopherR;Do,NhanV;Brophy,MaryT;Chitalia,Vipul;Ravid,Katya;Gaziano,JohnMichael;Fillmore,NathanaelR
• 通讯作者: Fillmore,NathanaelR