Acute Kidney Failure in a Cancer ICU

癌症 ICU 中的急性肾衰竭

• 批准号: 7034020
• 负责人: JOSHUA A SAMUELS
• 金额: $ 12.39万
• 依托单位: UNIVERSITY OF TEXAS HLTH SCI CTR HOUSTON
• 依托单位国家: 美国
• 财政年份: 2006
• 资助国家: 美国
• 起止时间: 2006-07-01 至 2011-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7034020
• 关键词: acute renal failure; cancer complication; cancer registry /resource; clinical research; disease /disorder onset; disease /disorder proneness /risk; environmental exposure; gene environment interaction; genetic markers; genetic polymorphism; genetic susceptibility; genotype; hospital length of stay; human data; human mortality; human population study; human subject; intensive care; mass spectrometry; mathematical model; model design /development; neoplasm /cancer; outcomes research; patient oriented research; prognosis

DESCRIPTION (provided by applicant): This proposal is for a Mentored Clinical Training Award (K23) for Dr. Joshua Samuels. The goal of this research is to provide career development and experience necessary to become a competitive independent clinical investigator, and to gain important knowledge regarding the development and outcome of acute kidney failure (AKF). The research will include patients admitted to the intensive care unit at MD Anderson Cancer Center (MDACC). Having already completed an MPH concentrating in Epidemiology, his didactic development plan includes Ph.D. level coursework at the UT-Houston School of Public Health, a period of laboratory training to gain facility with molecular epidemiology, and structured mentoring from two highly successful investigators. The protocol for the research is designed to facilitate his growth as a clinician-scientist and to evaluate clinical and genetic factors associated with AKF in critically ill patients with cancer. Cancer has become a leading cause of morbidity and mortality,with increasing hospitalization. AKF affects over 50,000 hospitalized Americans each year, and the mortality of patients with AKF in intensive care units has been reported as high as 86%. Current predictive models are inadequate to provide individualized prognostication. This study aims to refine predisposing clinical exposures and evaluate genetic markers that predict the onset and prognosis of AKF in critically ill cancer patients. The first phase uses a retrospective case-control design. Logistic and Cox regression modeling will be used to evaluate demographic and environmental exposure factors independently and in multivariate fashion to produce a final prediction model. Mortality and length of stay information will also be collected to evaluate associations between exposures and outcome. The second phase will prospectively validate the new clinical models and go further by evaluating multiple genetic polymorphisms as factors associated with AKF. The innovative addition of genetic analysis may provide enough improvement to allow patient specific prognostication. Overall, this study will allow for better prediction of AKF in ICU patients and better prognostication of their outcome. A better understanding of the risk factors and genetic susceptibility will allow quicker recognition of AKF and aid future research to develop more effective prevention or treatment options. The projects will launch the candidate into a career as an independent clinical investigator in Nephrology.

描述（由申请人提供）： 该建议是为Joshua Samuels博士提供指导的临床培训奖（K23）。这项研究的目的是提供成为竞争性独立临床研究者所必需的职业发展和经验，并获得有关急性肾衰竭（AKF）的发展和结果的重要知识。该研究将包括进入MD Anderson癌症中心（MDACC）重症监护病房的患者。他的教学发展计划已经完成了专注于流行病学的MPH专注于博士学位。 UT-Houston公共卫生学院的水平课程工作，这是一段实验室培训，以获得分子流行病学的设施，并从两位非常成功的研究人员那里进行结构化指导。该研究方案旨在促进他作为临床医生的成长，并评估与癌症癌症患者中与AKF相关的临床和遗传因素。随着住院的增加，癌症已成为发病率和死亡率的主要原因。 AKF每年影响超过50,000名住院的美国人，据报道，重症监护病房中AKF患者的死亡率高达86％。当前的预测模型不足以提供个性化的预后。这项研究旨在完善易感临床暴露并评估遗传标记，以预测重症癌症患者AKF的发作和预后。第一阶段使用回顾性案例对照设计。逻辑和COX回归建模将用于独立和多元方式评估人口统计学和环境暴露因素，以产生最终的预测模型。还将收集死亡率和住宿信息长度，以评估暴露与结果之间的关联。第二阶段将前瞻性地验证新的临床模型，并通过评估多种遗传多态性作为与AKF相关的因素来进一步发展。遗传分析的创新添加可以提供足够的改进，以允许患者特定的预后。总体而言，这项研究将允许在ICU患者中更好地预测AKF，并更好地预测其结果。更好地了解危险因素和遗传敏感性将使对AKF的认识更快，并帮助未来的研究以开发更有效的预防或治疗选择。这些项目将把候选人带入职业生涯，担任肾脏病的独立临床研究者。