Vitamin D hormones in CKiD: Prevalence of deficiency and clinical correlates.

CKiD 中的维生素 D 激素：缺乏症的患病率和临床相关性。

基本信息

批准号：
8535266
负责人：
Juhi Kumar
金额：
$ 15.49万
依托单位：
WEILL MEDICAL COLL OF CORNELL UNIV
依托单位国家：
美国
项目类别：
财政年份：
2009
资助国家：
美国
起止时间：
2009-09-21 至 2016-08-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/8535266
关键词：
1,25 (OH) vitamin D 14 year old 25-hydroxyvitamin D Adolescent Adult Age Albuminuria Apoptosis Award Blood Pressure Calcium Cardiovascular Diseases Cardiovascular system Cell Proliferation Child Childhood Chronic Kidney Failure Clinical Clinical Investigator Cohort Studies Data Databases Development Diagnosis Dialysis procedure Diet Disease Disease Progression End stage renal failure Enrollment Enzymes Epidemic Epidemiologic Studies Excretory function Failure Genes Grant Growth Growth and Development function Health Height Hemodialysis High Prevalence Homeostasis Hormones Hospitalization Hypertension Hypotension Intake Intestinal Absorption K-Series Research Career Programs Kidney Kidney Diseases Lead Left Ventricular Hypertrophy Lipids Low Prevalence Master&apos s Degree Measurement Measures Mixed Function Oxygenases Morbidity - disease rate National Health and Nutrition Examination Survey Neurocognitive Nutritional Outcome Parathyroid gland Participant Patients Phosphorus Population Prevalence Principal Investigator Proteinuria Protocols documentation Public Health Questionnaires Race Renal Osteodystrophy Research Research Design Research Personnel Research Proposals Risk Factors Role Secondary Hyperparathyroidism Serum Source Sun Exposure Time United States United States National Institutes of Health Visit Vitamin D Vitamin D Deficiency Vulnerable Populations aged angiogenesis cardiovascular disorder risk career cohort dietary supplements fibroblast growth factor 23 improved inorganic phosphate modifiable risk mortality novel patient oriented research programs prospective sex skills

项目摘要

DESCRIPTION (provided by applicant): The aim of this career development award is to become an independent investigator in patient-oriented research involving children with chronic kidney disease (CKD). The prevalence of pediatric end stage renal disease (ESRD) is 86.1/million. Despite the low prevalence, pediatric CKD carries significant morbidity and mortality. The expected remaining lifetime for a child, 0-14 years of age and on dialysis is only 20 years. The focus of research in pediatric CKD should be identification of risk factors for progression. Chronic Kidney disease in children (CKiD) is a prospective cohort study of kidney disease in children and adolescents aged 1-16 years. The aims of this epidemiologic study are to determine the risk factors for progression of chronic kidney disease and its effects on cardiovascular health, growth and neurocognitive development. Low vitamin D levels have recently emerged as a potential risk factor for CKD progression, because of their association with higher blood pressure and albuminuria.FGF-23 is a novel hormone that is a negative regulator of 1,25 dihydroxy vitamin D levels and has been shown to have an association with mortality in adult ESRD patients. For the initial part of the research proposal, data from the CKiD study will be used to determine the prevalence and correlates of 25 hydroxy vitamin D (25OHD) and 1,25 di hydroxy vitamin D [1,25(OH)2D] deficiency. A questionnaire will be developed to assess the intake of 25OHD from nutritional and environmental sources. Prevalence and correlates of 25OHD deficiency will be compared between the CKiD cohort and age and race matched controls in the NHANES 2001-2004 database. We propose to measure the levels of 1,25 (OH)2D and FGF-23 hormones in the CKiD population. The associations of 1,25 (OH)2 D with the progression of CKD and growth delay will be determined. The last part of our study will examine the determinants of FGF-23 and explore its role in the dysregulation of vitamin D hormone axis, progression of CKD and growth delay in pediatric CKD. My determination to have a successful career in research started with obtaining a Master's degree in Public Health and the K23 grant will further help me to acquire skills necessary to fulfill my aim of becoming an independent clinical investigator. PUBLIC HEALTH RELEVANCE: End stage renal disease is a world wide epidemic. There is an urgent need to find novel risk factors that would delay progression and improve outcomes in CKD. This K-23 study proposal aims to elucidate the role of novel risk factors for chronic kidney disease progression in one of the most vulnerable population to be afflicted by this disease.

描述（由申请人提供）：该职业发展奖的目的是成为涉及患有慢性肾脏疾病（CKD）的儿童研究的独立研究者。小儿终阶段肾病（ESRD）的患病率为86.1/百万。尽管患病率较低，但小儿CKD仍具有明显的发病率和死亡率。儿童预期的剩余寿命，0-14岁和透析仅20年。小儿CKD研究的重点应是确定进展的危险因素。儿童慢性肾脏疾病（CKID）是一项对1-16岁儿童和青少年肾脏疾病的前瞻性队列研究。这项流行病学研究的目的是确定慢性肾脏疾病进展的危险因素及其对心血管健康，生长和神经认知发展的影响。低维生素D水平最近已成为CKD进展的潜在危险因素，因为它们与较高的血压和蛋白尿相关。FGF-23是一种新型激素，是一种负调节剂，是1,25型二羟基维生素D水平的负调节剂，并且已证明与成年ESRD患者的死亡率相关。对于研究建议的最初部分，CKID研究的数据将用于确定25个羟基维生素D（25OHD）和1,25 DI羟基维生素D [1,25（OH）2d]缺陷的患病率和相关性。将开发问卷，以评估营养和环境来源的25OHD摄入量。在CKID队列与年龄和种族匹配的NHANES 2001-2004数据库中的年龄和种族匹配的对照组之间，将比较25OHD缺乏症的患病率和相关性。我们建议在CKID人群中衡量1,25（OH）2D和FGF-23激素的水平。将确定1,25（OH）2 D与CKD进展和生长延迟的关联。我们研究的最后一部分将检查FGF-23的决定因素，并探索其在维生素D激素轴失调，CKD的进展和小儿CKD的生长延迟中的作用。我决心在研究领域取得成功的职业始于获得公共卫生硕士学位，而K23赠款将进一步帮助我获得必要的技能，以实现我成为独立临床研究者的目标。公共卫生相关性：末期肾脏疾病是一种全球流行病。迫切需要寻找新的风险因素，以延迟进展并改善CKD的结果。这项K-23研究建议旨在阐明在最脆弱的人群中，慢性肾脏疾病进展的新风险因素的作用。