Cognitive Impairment in End Stage Renal Disease

项目总结 认知障碍影响大多数患有终末期肾病(ESRD)的老年人，并呈负面影响 影响他们的生活质量、医疗保健成本和健康结果。我们的长期目标是制定战略 目的：预防和治疗终末期肾病患者的认知障碍。我们的初步数据表明，特定的 随着肾脏移植，认知领域得到了改善，大脑结构也发生了相应的变化。 这些数据表明认知障碍和与之相关的脑结构改变的潜在可逆性。 使用ESRD。在这项计划中，我们将对终末期肾病患者肾脏前后进行纵向研究。 移植。通过比较终末期肾病患者和对照组的基线认知和脑MRI表现， 我们将更明确地定义在ESRD中受影响的认知领域，以及认知 与ESRD相关的损害对应于大脑的结构变化。通过比较认知能力 肾移植前后的功能和脑变化，我们将确定可逆性的程度 在认知和伴随而来的大脑结构变化中，这些结构变化可能在功能上调节 认知能力的提高。这项拟议的研究将精确定位认知功能和 ESRD的脑结构变化，并确定未来治疗的靶点。这项研究的数据还将确定 终末期肾病患者移植前后的认知缺陷。这一信息将对 终末期肾病患者的临床管理及教育方法。这位导师 以病人为导向的职业发展奖(K23)将为PI提供必要的培训和 通过教学和实践，具备认知功能评估、脑成像和临床研究方面的专业知识 课程、指导和应用经验。PI是一名移植肾病学家，他曾与 杰弗里·伯恩斯，医学博士，堪萨斯大学阿尔茨海默病中心联席主任；威廉·布鲁克斯， 霍格伦德脑成像中心主任David Johnson博士 堪萨斯大学阿尔茨海默病中心的神经心理学和马克·萨纳克医学博士和 在马萨诸塞州波士顿塔夫茨医学中心的ESRD认知障碍研究方面备受赞誉的研究员。这个独一无二的 专业知识的结合使我们的团队成为这项研究的理想选择。

PROJECT SUMMARY Cognitive impairment affects the majority of older adults with end stage renal disease (ESRD) and negatively impacts their quality of life, health care costs, and health outcomes. Our long-term goal is to develop strategies to prevent and treat cognitive impairment in patients with ESRD. Our preliminary data indicate that specific domains of cognition improve with kidney transplantation, with corresponding changes in brain structure. These data indicate potential reversibility in both cognitive impairment and structural brain changes associated with ESRD. In this proposal, we will longitudinally study patients with ESRD before and after kidney transplantation. By comparing baseline cognition and brain MRI findings between ESRD patients and controls, we will more firmly define the domains of cognition that are affected in ESRD, and whether cognitive impairment associated with ESRD corresponds to structural changes in the brain. By comparing cognitive function and brain changes before and after kidney transplantation, we will determine the extent of reversibility in cognition and in accompanying structural changes in the brain that may functionally regulate the improvements in cognition. The proposed research will pinpoint areas of reversibility in cognitive function and brain structural changes in ESRD and identify targets for future therapies. Data from this study will also identify cognitive deficits in both pre- and post- transplant patients with ESRD. This information will have implications in the clinical management of patients with ESRD and the methods used for patient education. This Mentored Patient-Oriented Career Development Award (K23) will provide the PI with the necessary training and expertise in cognitive function assessment, brain imaging, and clinical research through didactic and hands on courses, mentoring, and applied experiences. The PI is a transplant nephrologist who has collaborated with Jeffrey Burns, M.D., the Co-Director of University of Kansas Alzheimer's Disease Center; William Brooks, Ph.D, the Director of the Hoglund Brain Imaging Center, David Johnson, Ph.D, the Director of Neuropsychology at the University of Kansas Alzheimer's Disease Center and Mark Sarnak, M.D., an acclaimed investigator in cognitive impairment in ESRD at the Tufts Medical Center, Boston, MA. This unique combination of expertise makes our group ideal for this study.