Bone Health in Patients with Urinary Stone Disease

泌尿系结石患者的骨骼健康

• 批准号: 10370918
• 负责人: Calyani Ganesan
• 金额: $ 19.4万
• 依托单位: STANFORD UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-01-15 至 2026-11-30
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10370918
• 关键词: Alkalies; Award; Biological Markers; Bone Resorption; Calcium; Caring; Citrates; Clinic; Clinical; Clinical Investigator; Collection; Cross-Sectional Studies; Data; Data Set; Detection; Development; Diagnosis; Disease; Early Diagnosis; Early treatment; Equilibrium; Exhibits; Forteo; Fracture; Funding; Grant; Guidelines; Healthcare Systems; Hour; Hydroxyproline; Hypogonadism; Imaging Techniques; Institutes; Kidney Calculi; Knowledge; Measurement; Measures; Menopausal Status; Mentored Patient-Oriented Research Career Development Award; Mentorship; Monitor; Osteocalcin; Osteogenesis; Osteoporosis; Osteoporotic; Patient Care; Patient Recruitments; Patients; Peripheral; Persons; Pharmaceutical Preparations; Pharmacoepidemiology; Postmenopause; Provider; Quality of Care; Recurrence; Research; Research Infrastructure; Research Personnel; Resolution; Risk Factors; Scientist; Serum; Signal Transduction; Statistical Methods; Thick; Time; Training; United States Department of Veterans Affairs; Universities; Urinary Calculi; Urine; Veterans Health Administration; Vision; Work; X-Ray Computed Tomography; bisphosphonate; bone; bone health; bone imaging; bone strength; calcium metabolism; clinically significant; cohort; comorbidity; density; experience; fracture risk; high risk; imaging modality; improved; novel; patient oriented research; prevent; prospective; recruit; screening; screening guidelines; skeletal; skills; treatment guidelines

Project Summary This K23 proposal will provide Calyani Ganesan, MD, MS with dedicated time, mentorship, training, and research experience to become an independent clinical investigator. Dr. Ganesan is a clinician-scientist with a long-term vision of improving the quality of care for patients with urinary stones. Under the guidance of a strong mentorship team, she will acquire skills in: 1) advanced statistical methods used in pharmacoepidemiology studies; 2) the collection and analysis of prospective patient data; and 3) a novel bone imaging technique, high-resolution peripheral quantitative computed tomography (HR-pQCT), to assess skeletal status. This grant proposes to improve the screening and management of patients with urinary stone disease and diminished bone strength. Despite an increased risk of fracture in patients with urinary stone disease, there are currently no guidelines regarding the screening and treatment of osteoporosis in these patients. It is also unclear which medications might provide dual benefit in decreasing skeletal fragility and reducing stone recurrence in these patients. This project aims to: 1) identify patients with urinary stone disease who are at high risk for osteoporosis or fracture; 2) determine the effects of medications used to treat osteoporosis on urinary stone disease; and 3) identify the underlying bone deficits in patients with urinary stone disease using HR-pQCT and bone biomarkers reflecting bone formation and resorption. The first two aims will be answered by analyzing national data from the Veterans Health Administration (VHA) and Optum datasets. For the third aim, Dr. Ganesan will recruit patients with urinary stone disease from the Stanford University and Veterans Affairs Palo Alto Health Care System Kidney Stone clinics. She will use HR-pQCT and serum biomarkers to measure and monitor bone parameters over time in these patients. The proposed work has potential to make a significant clinical impact. Successful completion will enable clinicians to identify which patients with urinary stone disease should be screened osteoporosis and inform clinicians how best to treat these patients so that fracture associated comorbidity and recurrent stones can be reduced. The proposed work is realistic and feasible within the award period, and the research infrastructure at Stanford is already in place. Dr. Ganesan is poised to build on her research skills, advance and disseminate scientific knowledge, create additional collaborative networks, and eventually compete for R01 or equivalent funding. In summary, the K23 award will provide the support to enable Dr. Ganesan to become a successful independent clinical investigator.

项目概要 这项 K23 提案将为医学博士、理学硕士 Calyani Ganesan 提供专门的时间、指导、培训和 成为独立临床研究者的研究经验。 Ganesan 博士是一位临床医生兼科学家 提高尿路结石患者护理质量的长期愿景。在强大的指导下 在导师团队中，她将获得以下方面的技能：1）药物流行病学中使用的高级统计方法 研究； 2）前瞻性患者数据的收集和分析； 3）一种新颖的骨成像技术， 高分辨率外周定量计算机断层扫描 (HR-pQCT)，以评估骨骼状态。 该赠款旨在改善泌尿系结石患者的筛查和管理， 骨强度减弱。尽管泌尿系结石患者骨折的风险增加，但 目前尚无关于这些患者骨质疏松症筛查和治疗的指南。这也是 不清楚哪些药物可以提供降低骨骼脆性和减少结石的双重益处 这些患者的复发。该项目旨在：1) 确定患有泌尿系结石疾病的患者 骨质疏松或骨折的高风险； 2) 确定用于治疗骨质疏松症的药物对患者的影响 泌尿系结石病； 3) 使用以下方法确定泌尿系结石患者潜在的骨缺损 HR-pQCT 和反映骨形成和吸收的骨生物标志物。前两个目标将得到解答 通过分析退伍军人健康管理局 (VHA) 和 Optum 数据集的国家数据。对于第三个 为了实现这一目标，Ganesan 博士将从斯坦福大学和退伍军人中招募泌尿系结石患者 事务帕洛阿尔托医疗保健系统肾结石诊所。她将使用 HR-pQCT 和血清生物标志物 随着时间的推移，测量和监测这些患者的骨骼参数。 拟议的工作有可能产生重大的临床影响。成功完成将启用 临床医生确定哪些泌尿系结石患者应进行骨质疏松症筛查并告知 临床医生如何最好地治疗这些患者，以便能够消除与骨折相关的合并症和复发性结石 减少。拟议的工作在奖励期内是现实可行的，并且研​​究基础设施 斯坦福大学已经就位。 Ganesan 博士准备利用她的研究技能、推进和传播 科学知识，创建额外的协作网络，并最终竞争 R01 或同等水平 资金。总而言之，K23 奖将为 Ganesan 博士成为一名成功的医生提供支持。 独立的临床研究者。