Patient Oriented Research in Kidney Disease and Transplant Surgery

以患者为中心的肾脏疾病和移植手术研究

• 批准号: 8679374
• 负责人: DORRY L. SEGEV
• 金额: $ 18.56万
• 依托单位: JOHNS HOPKINS UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2014
• 资助国家: 美国
• 起止时间: 2014-04-15 至 2019-03-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8679374
• 关键词: Address; Adult; Ancillary Study; Area; Award; Breathing; Clinical; Cognition; Cohort Studies; Commit; Country; Creatinine; Data; Development; Dialysis patients; Dialysis procedure; Doctor of Philosophy; Educational Curriculum; Educational process of instructing; Elderly; End stage renal failure; Environment; Epidemiology; Face; Faculty; Family; Fellowship; Fostering; Friends; Funding; Future; Gender; Genotype; Grant; Health; Hospitalization; Immunosuppression; Individual; Infection; Institution; Interdisciplinary Study; Ischemia; Journals; K-Series Research Career Programs; Kidney; Kidney Diseases; Kidney Transplantation; Leadership; Learning; Living Donors; Longitudinal Studies; Measures; Medicare; Mentors; Mentorship; Methods; Metric; Modeling; Operative Surgical Procedures; Organ; Outcome; Paper; Patients; Physicians; Pilot Projects; Process; Prospective Studies; Protocols documentation; Publishing; Quality of life; Recording of previous events; Recurrence; Research; Research Personnel; Retrospective Studies; Right kidney; Risk; Scientist; Structure; Students; Subgroup; Surgeon; Time; Training; Transplant Recipients; Transplantation; Universities; Work; career development; clinical decision-making; cohort; cost; experience; frailty; improved; model design; mortality; multidisciplinary; next generation; non-genetic; patient oriented; patient oriented research; professor; psychosocial; skills; success

Summary Over 600,000 adults in the US suffer from ESRD. For the appropriate patients, kidney transplantation (KT) reduces mortality, improves quality of life, and saves substantial Medicare dollars. However, selecting patients for KT can be challenging, particularly among certain subgroups such as older adults, and current metrics are of limited utility in informing clinical decision-making. Furthermore, once selected for KT, patients face similar challenges when considering deceased donor offers or deciding if to allow friends or family to put themselves at risk as living donors. Predicting which patients would benefit from KT, and optimally matching them to the right donor, is one of the most critical concerns for patients, transplant physicians, and referring nephrologists. This is a proposal for a K24 Midcareer Investigator Award for Dorry Segev, MD, PhD, an Associate Professor of Surgery and Epidemiology at Johns Hopkins University. Dr. Segev leads three major R01-funded patient- oriented research efforts to address the challenges of ESRD and KT clinical decision-making: (1) A prospective study of frailty and risk prediction among older dialysis patients and kidney transplant recipients; (2) A retrospective study of long-term outcomes and survival benefit from incompatible live donor kidney transplantation; and (3) A multi-center longitudinal study of long-term sequelae of kidney donation. In addition to addressing the aims of the individual grants, these studies provide rich substrate for ancillary studies by mentees, including thousands of patients engaged in several cohorts, as well as many opportunities for advanced methodologic training. Dr. Segev is actively mentoring students, residents, fellows, and junior faculty in an exciting, productive multidisciplinary environment. This K24 will afford future mentees the opportunity to leverage Dr. Segev's rich ongoing research portfolio with the following new aims: (1) To better understand dialysis and KT outcomes important to older adults; (2) To quantify secondary risks of incompatible KT protocols; (3) To elucidate familial, genetic, and non-renal risks after kidney donation; (4) To design models to assist KT candidates with organ offer decisions; and (5) To expand Dr. Segev's capacity to mentor the next generation of clinician-scientists in ESRD and KT by pursuing formal training in mentoring, learning leadership skills from experts at JHU, continuing to foster multidisciplinary collaborations across the institution, connecting with mentors and mentees from across the country, and refining a curriculum for teaching patient-oriented research to surgeons and other clinicians

概括 美国有超过 600,000 名成年人患有 ESRD。对于合适的患者，肾移植（KT） 降低死亡率，提高生活质量，并节省大量医疗保险费用。然而，选择患者 对于 KT 来说可能具有挑战性，特别是对于老年人等某些亚群体，目前的指标是 在为临床决策提供信息方面作用有限。此外，一旦选择 KT，患者将面临类似的情况 在考虑已故捐赠者的提议或决定是否允许朋友或家人将自己置于自己的位置时面临的挑战 作为活体捐赠者面临风险。预测哪些患者将从 KT 中受益，并将他们与患者进行最佳匹配 正确的供体是患者、移植医生和转诊肾病专家最关心的问题之一。 这是为副教授 Dorri Segev 医学博士、哲学博士申请 K24 职业生涯中期研究员奖的提案 约翰·霍普金斯大学外科和流行病学博士。 Segev 博士领导了三个主要的 R01 资助的患者- 旨在解决 ESRD 和 KT 临床决策挑战的定向研究工作：（1）前瞻性研究 老年透析患者和肾移植受者的虚弱和风险预测研究； (2) A 不相容活体供肾的长期结果和生存获益的回顾性研究 移植； （3）捐肾长期后遗症的多中心纵向研究。此外 为了解决个人赠款的目标，这些研究为辅助研究提供了丰富的基础 受训者，包括参与多个队列的数千名患者，以及许多机会 高级方法培训。 Segev 博士积极指导学生、住院医师、研究员和初级教师 在一个令人兴奋、富有成效的多学科环境中。 这个 K24 将为未来的学员提供利用 Segev 博士丰富的持续研究成果的机会 以下新目标： (1) 更好地了解对老年人重要的透析和 KT 结局； (2) 至 量化不兼容的 KT 协议的次要风险； (3) 阐明家族性、遗传性和非肾脏风险 肾脏捐献后； （4）设计模型协助KT候选人进行器官录取决策； (5) 至 通过追求，扩大 Segev 博士指导下一代 ESRD 和 KT 临床医生科学家的能力 正规的指导培训，向 JHU 专家学习领导技能，继续培养多学科人才 整个机构的合作，与来自全国各地的导师和学员建立联系，以及 完善向外科医生和其他临床医生教授以患者为中心的研究的课程