Kidney Function and Aging

肾功能与衰老

• 批准号: 8069185
• 负责人: Lesley Ann Inker
• 金额: $ 16.97万
• 依托单位: TUFTS MEDICAL CENTER
• 依托单位国家: 美国
• 财政年份: 2008
• 资助国家: 美国
• 起止时间: 2008-05-01 至 2013-04-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8069185
• 关键词: Acidosis; Affect; Age; Aging; Agreement; Albumins; Albuminuria; Ancillary Study; Award; Bicarbonates; Biological Assay; Body Composition; Cardiovascular Diseases; Centers for Disease Control and Prevention (U.S.); Cessation of life; Characteristics; Chronic Disease; Chronic Kidney Failure; Clinical; Clinical Research; Cohort Studies; Collaborations; Complex; Creatinine; Cystatins; Data; Data Collection; Data Element; Data Set; Databases; Development; Development Plans; Diagnostic; Diet; Dietary Proteins; Disease; Dose; Elderly; Epidemiology; Equation; Ethnic Origin; Evaluation; Event; Filtration; Functional disorder; General Population; Geriatrics; Glomerular Filtration Rate; Goals; Health; Healthcare Systems; Human Subject Research; Individual; Inflammation; Institutes; Intake; Investigation; K-Series Research Career Programs; Link; Longevity; Malnutrition; Measurement; Measures; Mentors; Methods; Muscle Proteins; National Health and Nutrition Examination Survey; Normal Range; Nutritional; Outcome; Patients; Performance; Pharmaceutical Preparations; Physical activity; Pilot Projects; Population; Population Study; Prevalence; Proteins; Protocols documentation; Public Health; Race; Randomized Clinical Trials; Renal function; Reporting; Research; Research Methodology; Research Personnel; Research Project Grants; Risk Factors; Sample Size; Sampling; Science; Serum; Surveys; Testing; Time; Training; United States National Institutes of Health; Variant; adverse outcome; age related; aging nutrition; base; bone mass; career; career development; clinical decision-making; cohort; disability; experience; high risk; improved; indexing; inflammatory marker; interest; knowledge base; mortality; muscle form; muscle strength; nutrition; patient oriented; population based; post gamma-globulins; prognostic; programs; prospective; skills; tool; trend

DESCRIPTION (provided by applicant): The elderly are the fastest growing subset of the US population. Age-associated increases in chronic disease and disability represent a significant financial burden on the healthcare system. Glomerular filtration rate (GFR) declines with age and low GFR defines chronic kidney disease (CKD). Many older adults have CKD, which is an important risk factor for adverse outcomes. Accurate assessment of GFR is central to clinical decision-making, assessment of the public health burden, and investigation into the epidemiology of CKD in older adults. However, there is active debate about what constitutes "normal" level of GFR in older adults and the best method to assess it. Creatinine based GFR estimates may not be accurate in older adults as malnutrition and loss of muscle mass, common with age and disease, affect serum creatinine independent of GFR. Cystatin C is an altnernative filtration marker not influenced by diet and muscle mass. The overall goal of this research is to explore the relationship of kidney function and aging. Three aims are proposed: (1) Develop and validate GFR estimating eqations from cystatin C in the Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) database (N>65 years= 1306). (2) Examine relationships among estimated GFR based on cystatin C, aging, nutrition, body composition, and mortality in the National Health and Nutrition Examination Survey (NHANES) (N>60 years= 7525). (3) Conduct a pilot study to examine the level of measured GFR in the general population of older adults (N=100) for subsequent implementation of ancillary studies to measure GFR in ongoing prospective cohort studies to provide information on normal levels of GFR across age and populations. A mentored, patient oriented Career Development Award is proposed to provide the candidate with rigorous methodological training and experience in clinical research related to kidney function and aging. The candidate proposes research projects and a career plan that includes didactic courses, expert advising, and mentored research to enhance the candidate's skills in complex statistical analyses of population based and longitudinal data, primary data collection and human subjects research, and to expand the candidate's kidney function and clinical geriatrics knowledge base. These projects and career development plan are consistent with the recognition by the Center for Disease Control of aging and chronic kidney disease as major public health problems.

描述（由申请人提供）： 老年人是美国人口中增长最快的子集。与年龄相关的慢性疾病和残疾的增加代表了医疗保健系统的重大财务负担。随着年龄的增长，肾小球过滤率（GFR）下降，而GFR定义了慢性肾脏疾病（CKD）。许多老年人患有CKD，这是不良后果的重要危险因素。对GFR的准确评估对于临床决策，评估公共卫生负担以及对老年人CKD的流行病学的调查至关重要。但是，关于老年人的GFR构成的“正常”水平以及评估它的最佳方法存在积极的争论。基于肌酐的GFR估计值可能不准确，因为营养不良和肌肉质量的损失（常见于年龄和疾病）会影响血清肌酐独立于GFR。半胱氨酸蛋白酶C是不受饮食和肌肉质量影响的海拔过滤标记。这项研究的总体目标是探索肾功能和衰老的关系。提出了三个目的：（1）在慢性肾脏病流行病学合作（CKD-EPI）数据库中开发和验证Cystatin C中的GFR估计量估计（N> 65年= 1306）。 （2）在国家健康和营养检查调查（NHANES）（n> 60岁= 7525）中，基于半胱氨​​酸蛋白酶C，衰老，营养，身体成分和死亡率的估计GFR之间的关系。 （3）进行一项试验研究，以检查老年人普通人群（n = 100）的GFR水平，以便在正在进行的前瞻性队列研究中测量GFR，以提供有关跨年龄和人群正常水平的信息。提出了一个受过指导的，以患者为导向的职业发展奖，旨在为候选人提供与肾功能和衰老有关的临床研究的严格方法论培训和经验。候选人提出了研究项目和职业计划，其中包括教学课程，专家咨询和指导研究，以提高候选人在基于人群和纵向数据的复杂统计分析，主要数据收集和人类学科研究中的技能，并扩大候选人的肾脏功能和临床老年型知识库。这些项目和职业发展计划与对衰老和慢性肾脏疾病的疾病控制中心的认可是一致的。