Longitudinal Study of Dialysis

透析的纵向研究

• 批准号: 8125103
• 负责人: RULAN S PAREKH
• 金额: $ 70.2万
• 依托单位: JOHNS HOPKINS UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2007
• 资助国家: 美国
• 起止时间: 2007-09-01 至 2012-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8125103
• 关键词: Affect; African American; Age; Age Specific Death Rate; Angiography; Area; Autonomic nervous system disorders; Baltimore; Biological; Calcium; Candidate Disease Gene; Cardiovascular Diseases; Cardiovascular system; Cause of Death; Cholesterol; Chronic Kidney Failure; Clinical Trials; Cohort Studies; Coronary; Coronary Arteriosclerosis; Death Rate; Diabetes Mellitus; Dialysis patients; Dialysis procedure; End stage renal failure; Excess Mortality; Family; Future; Gender; General Population; Genes; Genetic; Heart Diseases; Hemodialysis; High Prevalence; Incidence; Inflammation; Investigation; Kidney Diseases; Left Ventricular Function; Left Ventricular Hypertrophy; Left ventricular structure; Longitudinal Studies; Magnesium; Measures; Methods; Metric; Morbidity - disease rate; Participant; Pathogenesis; Patients; Persons; Population; Potassium; Prospective Studies; Questionnaires; Race; Recruitment Activity; Regulation; Research; Research Infrastructure; Research Personnel; Risk; Risk Factors; Serum; Specific qualifier value; Specimen; Staging; Stenosis; Structure; Techniques; Testing; Time; Variant; Ventricular; Ventricular Arrhythmia; Work; X-Ray Computed Tomography; adjudicate; aged; calcium phosphate; cardiovascular risk factor; cigarette smoking; cohort; design; experience; follow-up; genetic risk factor; heart rate variability; high risk; inflammatory marker; mortality; prevent; programs; prospective; sudden cardiac death

DESCRIPTION (provided by applicant): Persons in the US with end stage renal disease (ESRD) have an annual mortality rate of over 20% and an age-specific death rate from cardiovascular disease that is 10-100 times higher than the general population. Much of this excess mortality is due to sudden cardiac death (SCD). Surprisingly, few prospective studies have examined risk factors for SCD in ESRD patients and these studies did not measure many risk factors known to be important in the general population. In the CHOICE cohort study, we found an SCD incidence of 18% over 4 years of follow up. Our overall hypothesis is that factors that increase risk for SCD in the general population are highly prevalent in the dialysis population and are independent predictors of altered autonomic tone, impaired ventricular conduction, and SCD. We propose a prospective, longitudinal study of 1,000 incident ESRD patients treated with hemodialysis to determine the cardiovascular, dialysis-related, and genetic risk factors leading to altered autonomic tone, impaired ventricular conduction, and SCD. Participants aged 18 and older will be recruited from the Baltimore area. We anticipate that 60% of the cohort will be African American and 50% will have diabetes. Techniques developed in other successful studies of ESRD by the investigative team will be used to recruit and follow participants. Coronary calcium, vessel stenosis, and left ventricular structure and function will be assessed using computed tomography (CT) and CT angiography at baseline; ECGs, questionnaires and biological specimens will be collected at baseline and annually. Heart rate variability, measures of QT duration, and presence of ventricular late potentials will be assessed by analysis of annual ECG recordings. Cause of death will be adjudicated using standard criteria. This study will also allow identification of dialysis-related risk factors for SCD and its intermediates that are unique to ESRD, setting the stage for clinical trials to test therapies to prevent SCD in this high risk population. In addition, the proposed work will provide an infrastructure to answer, in future studies, a host of questions related to the pathogenesis of morbidity and mortality in the ESRD population.

描述（由申请人提供）：美国患有末期肾脏疾病（ESRD）的人的年死亡率超过20％，心血管疾病的特异性死亡率比一般人群高10-100倍。这种过多的死亡率大部分是由于心脏突然死亡（SCD）。令人惊讶的是，很少有前瞻性研究检查了ESRD患者SCD的危险因素，这些研究并未衡量许多已知在普通人群中很重要的危险因素。在选择队列研究中，我们发现4年的随访中的SCD发病率为18％。我们的总体假设是，在透析人群中增加SCD风险的因素非常普遍，并且是自主性张力改变，心室传导受损和SCD的独立预测指标。我们提出了一项前瞻性，纵向研究，对1000例用血液透析治疗的ESRD患者确定心血管，透析相关和遗传危险因素，导致自主张力改变，心室传导受损，SCD。 18岁及以上的参与者将从巴尔的摩地区招募。我们预计60％的队列将是非裔美国人，而50％的人将患有糖尿病。调查小组在其他成功研究中开发的技术将用于招募和关注参与者。冠状动脉钙，血管狭窄以及左心室结构和功能将在基线时使用计算机断层扫描（CT）和CT血管造影评估； ECG，问卷和生物标本将在基线和每年收集。心率变异性，QT持续时间的度量以及心室后期电位的存在将通过对年度ECG记录的分析进行评估。死亡原因将使用标准标准进行裁决。这项研究还将允许鉴定ESRD独有的SCD及其中间体与透析相关的危险因素，这为临床试验奠定了基础，以测试疗法，以防止SCD在此高风险人群中。此外，拟议的工作将提供一个基础设施，以回答以后的研究，这是与ESRD人群发病率和死亡率有关的许多问题。

项目成果

Rationale and design for the Predictors of Arrhythmic and Cardiovascular Risk in End Stage Renal Disease (PACE) study.

• DOI: 10.1186/s12882-015-0050-4
• 发表时间: 2015-04-24
• 期刊: BMC nephrology
• 影响因子: 2.3
• 作者: Parekh RS;Meoni LA;Jaar BG;Sozio SM;Shafi T;Tomaselli GF;Lima JA;Tereshchenko LG;Estrella MM;Kao WH
• 通讯作者: Kao WH

Cross-sectional association of volume, blood pressures, and aortic stiffness with left ventricular mass in incident hemodialysis patients: the Predictors of Arrhythmic and Cardiovascular Risk in End-Stage Renal Disease (PACE) study.

• DOI: 10.1186/s12882-015-0131-4
• 发表时间: 2015-08-07
• 期刊: BMC nephrology
• 影响因子: 2.3
• 作者: Kim ED;Sozio SM;Estrella MM;Jaar BG;Shafi T;Meoni LA;Kao WH;Lima JA;Parekh RS
• 通讯作者: Parekh RS

Obstructive Sleep Apnea Increases Sudden Cardiac Death in Incident Hemodialysis Patients.

• DOI: 10.1159/000489963
• 发表时间: 2018
• 期刊: American journal of nephrology
• 影响因子: 4.2
• 作者: Kerns ES;Kim ED;Meoni LA;Sozio SM;Jaar BG;Estrella MM;Parekh RS;Bourjeily G
• 通讯作者: Bourjeily G

Association of Arterial Stiffness and Central Pressure With Cognitive Function in Incident Hemodialysis Patients: The PACE Study.

• DOI: 10.1016/j.ekir.2017.07.013
• 发表时间: 2017-11
• 期刊: Kidney international reports
• 影响因子: 6
• 作者: Kim ED;Meoni LA;Jaar BG;Shafi T;Linda Kao WH;Estrella MM;Parekh R;Sozio SM
• 通讯作者: Sozio SM

Calcification Biomarkers, Subclinical Vascular Disease, and Mortality Among Multiethnic Dialysis Patients.

• DOI: 10.1016/j.ekir.2020.07.033
• 发表时间: 2020-10
• 期刊: Kidney international reports
• 影响因子: 6
• 作者: Fitzpatrick J;Kim ED;Sozio SM;Jaar BG;Estrella MM;Monroy-Trujillo JM;Parekh RS
• 通讯作者: Parekh RS