Identifying and Mitigating Risk Factors for Dehydration-Mediated Nephrolithiasis in Adolescents

 描述（由申请人提供）：K23患者导向研究职业发展奖的候选人旨在成为儿科肾结石研究的国际领导者，在使用创新干预措施以提高治疗依从性和减少青少年肾结石复发方面具有特别的专业知识。拟议的指导研究和职业发展计划通过识别和减轻青少年脱水介导的肾结石的风险因素来促进这一职业目标。环境温度过高和过低会导致脱水，并增加成年人患肾结石的风险，但温度对青少年结石风险的影响尚不清楚，青少年特别容易受到极端温度的影响。水是减少肾结石发生的一种具有成本效益的方法;然而，尽管脱水在患有结石的青少年中很常见，但没有研究确定了饮水的障碍或制定了增加这一人群饮水量的干预措施。目的1将确定与青少年和成人肾结石表现相关的温度阈值差异。目标2将利用通过移动的设备收集的实时数据，确定肾结石青少年的饮水障碍。目的3将测量移动终端水化提醒器对草酸钙肾结石青少年尿草酸钙过饱和度和尿量的即时和持续影响。候选人在一家大型城市儿童医院担任小儿泌尿外科医生，并接受过临床流行病学培训。他的职业发展的一个组成部分将是与一个优秀的多学科指导团队的持续关系。候选人的主要导师是Susan Furth MD，PhD。Furth博士是慢性肾病儿童治疗依从性方面的国际专家，并拥有出色的指导记录。罗恩凯伦医学博士，公共卫生硕士，道格拉斯Wiebe博士和珍妮特Audrain-McGovern博士，将分别担任临床试验，青少年健康的生态瞬时评估和青少年健康的生物行为决定因素领域的共同导师。一个咨询小组将帮助指导候选人的职业发展，并将提供代谢性肾结石疾病、青少年用水、生物统计学和使用手机游戏改善健康方面的专业知识。拟议的研究和培训计划将扩大候选人在先进的统计分析，临床试验和应用技术来改善健康方面的专业知识，并将为候选人提供作为一名成功的独立研究人员所需的技能和经验，专注于研究新的干预措施，以提高治疗依从性并减少青少年肾结石复发。

 DESCRIPTION (provided by applicant): The candidate for this K23 Patient Oriented Research Career Development Award aims to become an international leader in pediatric nephrolithiasis research, with particular expertise in using innovative interventions to increase treatment adherence and decrease kidney stone recurrence among adolescents. The proposed mentored research and career development plan facilitates this career goal by identifying and mitigating risk factors for dehydration-mediated nephrolithiasis in adolescents. High and low ambient temperatures lead to dehydration and increase nephrolithiasis risk among adults, but the effect of temperature on stone risk in adolescents, who are particularly susceptible to temperature extremes, is unknown. Water is a cost-effective way to decrease kidney stone occurrence; however, despite dehydration being common among adolescents with stones, no studies have identified barriers to water intake or developed interventions to increase water intake in this population. Aim 1 will determine differences in the temperature thresholds associated with kidney stone presentation among adolescents and adults. Aim 2 will identify barriers to water intake among adolescents with kidney stones using real-time data gathered through mobile devices. Aim 3 will measure the immediate and sustained effect of mobile device hydration reminders on urine calcium oxalate supersaturation and urine volume in adolescents with calcium oxalate kidney stones. The candidate brings to this proposal experience as a pediatric urological surgeon at a large urban children's hospital and training in clinical epidemiology. An integral part of his career development will be continued relationship with an outstanding multidisciplinary mentoring team. The candidate's primary mentor is Susan Furth MD, PhD. Dr. Furth is an international expert in treatment adherence among children with chronic kidney disease and has an outstanding track-record of mentorship. Ron Keren MD, MPH, Douglas Wiebe PhD, and Janet Audrain-McGovern PhD, will serve as co-mentors in the areas of clinical trials, ecological momentary assessment of adolescent health, and biobehavioral determinants of adolescent health, respectively. An advisory panel will help guide the candidate's career development and will provide expertise in metabolic kidney stone disease, water access among adolescents, biostatistics, and using mobile games to improve health. The proposed research and training plan will expand the candidate's expertise in advanced statistical analysis, clinical trials, and applying technology to improve health, and will provide the candidate with the skills and experience necessary for a career as a successful independent researcher focused on investigating novel interventions to improve treatment adherence and decrease kidney stone recurrence among adolescents.