SEARCH-CKD: The nature of chronic kidney disease and elevated blood pressure in sub-Saharan Africa.

项目概要/摘要：通过这个K23奖，Anthony Muiru博士将获得知识， 技能和专业知识，成为以患者为导向的慢性疾病临床研究的领先研究者 肾脏疾病（CKD）和血压升高（BP）在最近的非洲血统的人。期间 肾奖学金，他利用基础设施的可持续东非研究社区卫生 （3）研究确定慢性肾脏病在东非农村的流行病学。他建立了搜索CKD 这项研究包括来自乌干达和肯尼亚农村地区的3，686名参与者的代表性样本。关键 SEARCH-CKD的初步研究结果包括：1）不明原因的白细胞尿的高患病率， 血尿; 2）CKD患病率的显著地理差异; 3） CKD患者。Muiru博士打算对这些初步的SEARCH-CKD结果进行随访， 以下目标：1）将SEARCH-CKD从横断面研究转变为纵向队列研究; 2） 在纵向队列管理、生物样本收集和后续管理方面获得实践经验 分析物的测量; 3）获得先进的流行病学和生物统计学方法的专业知识， 环境流行病学;和4）获得高血压专家认证。为了实现这些目标， 博士Muiru已经组建了一个由导师和顾问组成的多学科团队，他将参加一个定制的 在课程选择方面，将继续利用联合国海洋法公约研究建立的基础设施。 CKD导致血压升高，血压升高反过来又加速CKD进展。这两个人的负担 在撒哈拉以南的非洲地区，情况急剧恶化。这个K23奖将允许Muiru博士解决关键问题。 了解东非农村地区CKD和BP升高方面的知识差距，并为他提供支持， 指导必要的，以实现以下目标：1）确定白细胞尿的意义， 在生活在东非农村的个体中观察到血尿; 2）检查CKD的潜在风险因素， 可能解释了东非农村CKD患病率的地理差异，3）定义了 通过获得标准化单个时间点BP测量，患有CKD（~一半HIV阳性）的参与者 随后进行24小时动态血压测量。该提案将为Muiru博士提供一个 宝贵的培训平台，将推动他进入一个独立的研究生涯。此外，拟议的 这项研究将促进我们对肾脏疾病和最近非洲人血压升高的理解。 祖先

PROJECT SUMMARY/ABSTRACT: Through this K23 award, Dr. Anthony Muiru will obtain the knowledge, skills, and expertise necessary to become a leading investigator in patient-oriented clinical research of chronic kidney disease (CKD) and elevated blood pressure (BP) among people of recent African ancestry. During his renal fellowship, he leveraged the infrastructure of the Sustainable East Africa Research in Community Health (SEARCH) study to define the epidemiology of CKD in rural East Africa. He established the SEARCH-CKD study, comprising a representative sample of 3,686 SEARCH participants from rural Uganda and Kenya. Key findings from initial work in SEARCH-CKD included: 1) High prevalence of unexplained leukocyturia and hematuria; 2) a striking geographic variation in CKD prevalence; and 3) high prevalence of elevated BP among individuals with CKD. Dr. Muiru intends to follow up on these initial SEARCH-CKD findings to achieve the following goals: 1) transform SEARCH-CKD from a cross-sectional study into a longitudinal cohort study; 2) gain hands-on experience in longitudinal cohort management, collection of bio-samples and subsequent measurement of analytes; 3) acquire expertise in advanced epidemiological and biostatistical methods, environmental epidemiology; and 4) obtain certification as a hypertension specialist. To achieve these goals, Dr. Muiru has assembled a multidisciplinary team of mentors and advisors, he will enroll in a customized selection of courses, and will continue to leverage the infrastructure established by the SEARCH study. CKD leads to elevated BP and elevated BP in turn accelerates CKD progression. The burden of these two conditions is growing dramatically in sub-Saharan Africa. This K23 award will allow Dr. Muiru to address key knowledge gaps in regard to CKD and elevated BP in rural East Africa and provide him with the support and mentorship necessary to accomplish the following aims: 1) determine the significance of leukocyturia and hematuria observed among individuals living in rural East Africa; 2) examine potential risk factors for CKD that may explain the geographic variation in CKD prevalence in rural East Africa, 3) define BP phenotypes among participants with CKD (~half HIV-positive) by obtaining standardized single time-point BP measurement followed by 24-hr ambulatory blood pressure measurement. This proposal will provide Dr. Muiru with an invaluable training platform that will propel him into an independent research career. In addition, the proposed research will advance our understanding of kidney disease and elevated BP among people of recent African ancestry.