Patient Oriented Research in Kidney Disease

 描述（由申请人提供）：徐志远，医学博士，理学硕士正在申请更新他的职业中期研究者奖在面向患者的研究（K24），以支持他的原创研究和指导工作。K24特别支持的新研究的重点是终末期肾病（ESRD）。徐博士研究的一个长期的潜在主题是慢性肾脏病（CKD），包括从CKD到ESRD的转变，这导致他目前对ESRD事件的兴趣。本提案阐述了我们目前如何表征新发ESRD患者，报告的新发ESRD病例数量如何受到启动肾脏替代治疗（RRT）阈值的严重影响，以及新发ESRD患者的早期结局如何与ESRD前临床事件相关。目的1：确定目前ESRD患者特征描述的准确性。目的2：量化终末期肾病患者的数量如何因慢性透析的阈值和开始时间而变化。目标3：更好地了解事件ESRD患者的早期结局，包括早期死亡和恢复，以及它们如何与ESRD前临床事件相关。徐博士有一个非常强大的导师和工作在丰富的，支持和合议制度的环境中UCSF之前的跟踪记录。K24的持续资助将使许博士能够将更多的时间花在研究和指导上，而将更少的时间花在行政和临床工作上。

 DESCRIPTION (provided by applicant): Chi-yuan Hsu, MD, MSc is applying to renew his Mid-career Investigator Award in Patient Oriented Research (K24) in order to buttress his original research and mentorship efforts. The focus of the new research to be specifically supported by this K24 is incident end-stage renal disease (ESRD). A long-standing underlying theme of Dr. Hsu's research has been chronic kidney disease (CKD), including the transition from CKD to ESRD, which leads to his current interest in incident ESRD. This proposal addresses how we currently characterize new ESRD patients, how the reported number of new ESRD cases may be heavily influenced by threshold to initiate renal replacement therapy (RRT) and how early outcomes among incident ESRD patients are related to pre-ESRD clinical events. Aim 1: To determine the accuracy of how incident ESRD patients are currently characterized. Aim 2: To quantify how the number of incident ESRD patients vary by the threshold and timing of initiation of chronic dialysis. Aim 3: To better understand early outcomes among incident ESRD patients, including early death and recovery, and how they are related to pre-ESRD clinical events. Dr. Hsu has a very strong prior track record of mentorship and works within the rich, supportive and collegial institutional environment at UCSF. Continued K24 funding will permit Dr. Hsu to spend more time on research and mentoring and less time on administrative and clinical work.