Prevalence and Impact of Frailty among Dialysis Patients

项目摘要/摘要 我正在申请续签我的以患者为中心的研究(K24)职业中期研究员奖，以便 支持我的研究和指导工作。我完全致力于以病人为中心的研究和培训 肾脏病研究的下一代研究人员。我已经制定了一个研究计划，学习物理 透析患者的功能，描述他们的局限性，研究其病理生理学，并评估 改善功能的干预措施。虽然我之前和现在资助的工作旨在评估脆弱性和它的 在透析患者中的演变，我相信身体功能和虚弱可能会增加重要的 为慢性肾脏病其他病程的临床护理提供信息。特别是，我计划扩大我的 重点关注从需要CKD的非透析到ESRD的护理过渡以及从透析到移植的过渡。 目的是检查CKD期间的功能状态与ESRD期间结果的相关性 一组退伍军人和一组肾移植候选人的体能表现 确定移植后的结果在多大程度上与体能和身体虚弱有关 移植前评估。我有很好的指导记录，我在一个富有的，支持的，和 加州大学旧金山分校和肾病科的大学环境。继续提供K24资金将使我能够 继续把更多的时间集中在研究和指导上，而不是临床和行政工作上。

PROJECT SUMMARY/ABSTRACT I am applying to renew my Mid-career Investigator Award in Patient Oriented Research (K24) in order to support my research and mentoring efforts. I am fully committed to patient oriented research and to training the next generation of researchers in nephrology research. I have developed a research program studying physical functioning in patients on dialysis, characterizing their limitations, studying the pathophysiology, and evaluating interventions to improve functioning. While my previous and currently funded work aims to assess frailty and its evolution among patients on dialysis, I am convinced that physical function and frailty could add important information to inform clinical care at other points along the spectrum of CKD. In particular, I plan to expand my focus to the transitions of care from non-dialysis requiring CKD to ESRD and from dialysis to transplantation. Aims are to examine associations of functional status during CKD with outcomes during ESRD in a national cohort of veterans and to measure physical performance in a cohort of kidney transplant candidates to determine the extent to which post-transplant outcomes are related to physical performance and frailty during pre-transplant evaluation. I have a strong track record of mentoring, and I work within a rich, supportive, and collegial environment at UCSF and in the Division of Nephrology. Continued K24 funding will permit me to continue to focus more of my time on research and mentoring and less on clinical and administrative work.