Racial Disparities in Chronic Kidney Disease and Vitamin D: Are they related?

慢性肾病和维生素 D 的种族差异：它们是否相关？

• 批准号: 7474712
• 负责人: Michal L Melamed
• 金额: $ 13.63万
• 依托单位: ALBERT EINSTEIN COLLEGE OF MEDICINE
• 依托单位国家: 美国
• 财政年份: 2007
• 资助国家: 美国
• 起止时间: 2007-09-01 至 2012-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7474712
• 关键词: Affect; African American; Age; Albumins; Albuminuria; Alcohol consumption; Behavioral; Blood Pressure; Calcium; Cardiovascular Diseases; Cardiovascular system; Cessation of life; Chronic Kidney Failure; Clinical; Clinical Investigator; Communities; Congestive Heart Failure; Controlled Clinical Trials; Creatinine; Data; Data Sources; Dialysis procedure; Diet; Disease; Disease Outcome; Disease Progression; Dose; Eating; Elderly; End stage renal failure; Endocrine; Epidemic; Excretory function; Freezing; Funding; Future; General Population; Goals; Grant; Hemodialysis; Hispanics; Homeostasis; Incidence; Individual; Intake; Intervention; K-Series Research Career Programs; Kidney Diseases; Knowledge; Label; Laboratories; Life; Malignant Neoplasms; Masks; Master' s Degree; Measures; Medical center; Medicare; Mentors; National Health and Nutrition Examination Survey; National Research Service Awards; Nephrology; Other Minority; Outcome; Participant; Patient Care; Patients; Physical Dialysis; Placebo Control; Population; Postmenopause; Property; Race; Randomized; Randomized Clinical Trials; Rate; Recommendation; Renin-Angiotensin System; Research; Research Personnel; Research Proposals; Risk; Risk Factors; Safety; Sampling; Secondary Hyperparathyroidism; Serum; Smoke; Specimen; Staging; Sun Exposure; Sunlight; Supplementation; Surveys; Testing; United States; United States National Center for Health Statistics; Urine; Vitamin D; Vitamin D Deficiency; Woman; Women' s Health; base; bone; cardiovascular risk factor; career; clinical epidemiology; design; dietary supplements; dosage; improved; indexing; mortality; novel; patient oriented research; programs; racial difference; steroid hormone

DESCRIPTION (provided by applicant): My goal for this career development award is to become an excellent independent investigator in patient-oriented research in chronic kidney disease progression. Chronic kidney disease (CKD) and end-stage renal disease (ESRD) are world-wide epidemics with an estimated 19 million people living with CKD and over 300,000 treated with dialysis in the United States. African-Americans and other minorities are disproportionately affected by ESRD with an incidence rate that is almost fourfold that of whites. Risk factors of initiation and progression of CKD and the factors underlying the racial disparities in ESRD have not been fully elucidated. Vitamin D has anti-proliferative and immunomodulatory properties and functions as an endocrine regulator of the renin-angiotensin system. As such, low levels of vitamin D are a potential novel risk factor for progression of CKD. In addition, African-Americans and Hispanics in the United States have lower vitamin D levels than whites, making differences in vitamin D a possible contributor to the differential CKD progression between African-Americans, Hispanics and whites. The first part of my research proposal will use data from the Women's Health Initiative to explore the factors underlying the differences in vitamin D levels between AA and whites. I will then use data from the NHANES III mortality and Medicare linkages to assess associations between low vitamin D levels and all-cause and cardiovascular-specific mortality and incident ESRD. If these associations exist, I will then evaluate whether differences in vitamin D levels may explain the racial disparities in ESRD. My third aim will be to conduct a randomized clinical trial of vitamin D repletion in a multi-ethnic population with CKD, vitamin D deficient and albuminuria to evaluate correction of vitamin D levels, and reductions in albuminuria and blood pressure. I have already proven my commitment and ability to become a successful clinical investigator by obtaining a Master's degree in Clinical Epidemiology and obtaining independent funding as a nephrology fellow through an individual NRSA. This K23 grant will allow me to develop my career through advanced formal coursework, intensive mentoring and the design, planning and conduct of a randomized clinical trial.

描述（由申请人提供）： 我获得职业发展奖的目标是成为慢性肾脏疾病进展研究的出色独立研究者。慢性肾脏疾病（CKD）和终阶段肾脏疾病（ESRD）是全球流行病学的，估计有1900万人患有CKD，超过30万人在美国接受了透析。非裔美国人和其他少数民族受ESRD的影响不成比例，其发病率几乎是白人的四倍。 CKD的启动和进展的危险因素以及ESRD中种族差异的基础因素尚未完全阐明。维生素D具有抗增殖和免疫调节特性，并且是肾素 - 血管紧张素系统的内分泌调节剂。因此，低水平的维生素D是CKD进展的潜在新型风险因素。此外，美国的非裔美国人和西班牙裔人的维生素D含量低于白人，这使维生素D的差异成为非裔美国人，西班牙裔和白人之间差异CKD进展的可能性。我的研究建议的第一部分将使用妇女健康计划中的数据来探讨AA和白人之间维生素D水平差异的因素。然后，我将使用NHANES III死亡率和Medicare联系的数据来评估低维生素D水平与全因与心血管特异性死亡率和事件ESRD之间的关联。如果存在这些关联，我将评估维生素D水平的差异是否可以解释ESRD的种族差异。我的第三个目的是在具有CKD，维生素D缺乏症和蛋白尿的多种族人群中进行维生素D补充的随机临床试验，以评估维生素D水平的校正，以及蛋白尿和血压的降低。我已经证明了自己的承诺和能力通过获得临床流行病学硕士学位并通过单个NRSA获得肾脏病研究员的独立资金来成为成功的临床研究者。这项K23赠款将使我能够通过高级正式课程，密集的指导以及随机临床试验的设计，计划和行为来发展自己的职业。