Determinants of the Incidence and Outcome of Acute Renal Failure

急性肾衰竭发生率和结果的决定因素

• 批准号: 7364582
• 负责人: Sushrut S. Waikar
• 金额: $ 13.59万
• 依托单位: BRIGHAM AND WOMEN'S HOSPITAL
• 依托单位国家: 美国
• 财政年份: 2007
• 资助国家: 美国
• 起止时间: 2007-04-01 至 2012-03-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7364582
• 关键词: Abdominal Aortic Aneurysm; Acute; Acute Kidney Failure; Acute Renal Failure with Renal Papillary Necrosis; Address; Admission activity; Advisory Committees; Area; Biological Markers; Boston; California; Cardiac Catheterization Procedures; Characteristics; Cisplatin; Clinical; Clinical Investigator; Complication; Condition; Conflict (Psychology); Creatinine; Data; Data Sources; Databases; Development; Diabetes Mellitus; Dose; Early identification; Educational process of instructing; Elevation; Ensure; Epidemiologist; Epidemiology; Ethnic Origin; Experimental Models; Faculty; Functional disorder; Gelatinase A; Gelatinase B; General Hospitals; Glucosaminidase; High Prevalence; Hispanics; Hospital Mortality; Hospitalization; Hospitals; Hour; Hypertension; Incidence; Injury; Inpatients; Intensive Care Units; Internal Medicine; Intravenous; Ischemia; K-Series Research Career Programs; Kidney; Kidney Failure; Laboratories; Lead; Length; Link; Literature; Malignant neoplasm of testis; Massachusetts; Medical; Mentors; Nephrology; Operative Surgical Procedures; Outcome; Patients; Pharmaceutical Preparations; Postoperative Period; Predisposition; Public Health Schools; Race; Registries; Research; Research Personnel; Research Training; Risk; Risk Factors; Sample Size; Sampling; San Francisco; Serum; Sex Characteristics; Standards of Weights and Measures; Teaching Hospitals; Testing; Testosterone; Training; Tubular formation; United States; Universities; Urine; Woman; administrative database; career; chemotherapy; clinically relevant; cohort; day; experience; medical schools; men; mortality; novel; pressure; prognostic; programs; prospective; racial difference; rat KIM-1 protein; repaired; sex; skills; success; training project; urinary

DESCRIPTION (provided by applicant): Dr. Sushrut Waikar received his MD degree from Yale University School of Medicine, trained in internal medicine at the University of California, San Francisco, and will join the nephrology faculty at Bigham and Women's Hospital on July 1, 2006. He is currently a candidate for the MPH degree from the Harvard School of Public Health. Mentor: Dr. Gary Curhan is a renowned renal epidemiologist with a long track record of successfully mentoring trainees. Along with a team of leading researchers selected for Dr. Waikar's advisory committee, Dr. Curhan will ensure the success of Dr. Waikar's research training, project, and overall career development. Research: Acute renal failure (ARF) is a common and often devastating complication in hospitalized patients. Despite considerable research efforts to clarify the epidemiology and pathophysiology of ARF, important gaps remain. This proposal aims to contribute to two major areas in ARF research: 1) to address unresolved epidemiologic questions regarding race/ethnicity, sex, and hospital factors that may influence the incidence of and mortality associated with ARF; and 2) to identify novel urinary biomarkers to enable the early identification of acute kidney injury (AKI) and its consequences. For Specific Aim 1 we will use two large databases to investigate the epidemiology of ARF in hospitalized patients: a) the Nationwide Inpatient Sample, the largest all-payer administrative database of hospitalizations in the United States with data on 5 to 8 million admissions annually; and b) the Research Patient Data Registry, a unique database developed at Brigham and Women's Hospital and Massachusetts General Hospital which contains linked administrative, medication, and laboratory data on over 300,000 patients. For Specific Aim 2 we will test four markers of tubular injury in a spectrum of patients at risk of kidney injury. We will test kidney injury molecule 1 (KIM-1), neutrophil gelatinase-associated lipocalin (NGAL), matrix metalloproteinase-9 (MMP-9), and N-acetyl-glucosaminidase (NAG) for the ability to identify AKI at least 24 hours prior to a rise in serum creatinine of (= 0.5 mg/dL; we will also test whether urinary biomarkers can identify currently 'sub-clinical' kidney injury, and what independent prognostic information on clinical outcomes may be heralded by urinary biomarker elevations. At the completion of this career development award, Dr. Waikar will have a unique combination of skills and experience that will enable him to succeed as an independent clinical investigator.

描述（由申请人提供）： Sushrut Waikar博士获得了耶鲁大学医学院的医学博士学位，并于2006年7月1日在加利福尼亚大学旧金山大学接受内科培训，并将加入Bigham和女子医院的肾脏科学院。他目前是哈佛大学公共卫生学院MPH学位的候选人。导师：加里·库尔汉（Gary Curhan）博士是一位著名的肾脏流行病学家，拥有成功指导学员的悠久记录。库尔汉博士将与一组首席研究人员一起为Waikar博士的咨询委员会选拔，将确保Waikar博士的研究培训，项目和整体职业发展的成功。研究：急性肾衰竭（ARF）是住院患者常见且经常毁灭性的并发症。尽管阐明ARF的流行病学和病理生理学的大量研究工作仍然存在。该建议旨在为ARF研究的两个主要领域做出贡献：1）解决有关种族/民族，性​​别和医院因素的未解决的流行病学问题，这些问题可能影响与ARF相关的发生率和死亡率； 2）确定新型的尿生物标志物以使急性肾损伤（AKI）及其后果的早期鉴定。对于特定目的1，我们将使用两个大型数据库来调查住院患者ARF的流行病学：a）全国范围内住院样本，这是美国住院治疗的最大全付款人行政数据库，每年提供5至800万个入院数据； b）研究患者数据注册表是在杨百翰，妇女医院和马萨诸塞州综合医院开发的独特数据库，其中包含有关超过30万名患者的行政，药物和实验室数据。对于特定目标2，我们将在一系列有肾脏损伤风险的患者中测试四个肾小管损伤标记。我们将测试肾脏损伤分子1（KIM-1），中性粒细胞明胶酶相关的脂蛋白（NGAL），基质金属蛋白酶9（MMP-9）和N-乙酰基葡萄糖氨基氨基酶（NAG）（NAG），至少在Serum cretim inm cretin nerum cretinnimine wher-ner testiry ner（nag）中，nag;生物标志物可以识别当前“临界”的肾脏损伤，并且在该职业发展奖的完成时，可能会因临床结果的独立预后提供有关临床结果的独立信息，Waikar博士将拥有独特的技能和经验，使他能够成功成为独立的临床研究者。