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60万名成年人患有ESRD。对于适当的患者，肾脏移植（KT） 降低死亡率，改善生活质量并节省大量的医疗保险资金。但是，选择患者 因为KT可能具有挑战性，尤其是在某些亚组（例如老年人）中，当前的指标是 在告知临床决策方面有限的实用性。此外，一旦被选为KT，患者面临相似的 考虑已故捐赠者的要约或决定是否允许朋友或家人提出挑战 作为活捐助者的风险。预测哪些患者将从KT中受益，并将其最佳匹配到 右捐助者是患者，移植医师和参考肾病学家的最关键问题之一。 这是副教授Dorry Segev，医学博士Dorry Segev，医学博士学位的K24中级调查员奖的建议 约翰·霍普金斯大学的手术和流行病学。 Segev博士领导三名主要R01资助的患者 - 针对ESRD和KT临床决策挑战的方向研究工作：（1） 研究老年透析患者和肾脏移植受者中脆弱和风险预测的研究； （2）a 回顾性研究不相容的活捐赠者肾脏对长期结果和生存益处 移植； （3）肾脏捐赠的长期后遗症的多中心纵向研究。此外 为了解决各个赠款的目的，这些研究为辅助研究提供了丰富的衬底 受训者，包括成千上万的患者，从事几个同伙，以及许多机会 先进的方法学培训。 Segev博士正在积极指导学生，居民，研究员和初级教师 在令人兴奋的生产性多学科环境中。 这款K24将为未来的受训者提供机会，以利用Segev博士的丰富研究组合与 以下新目标：（1）更好地了解透析和KT结果对老年人很重要； （2）至 量化不兼容的KT方案的次要风险； （3）阐明家族，遗传和非肾脏风险 肾脏捐赠后； （4）设计模型以协助KT候选人进行器官提供决定； （5）到 扩大Segev博士通过追求ESRD和KT的下一代临床医生的能力 指导，从JHU专家学习领导技能的正式培训，继续培养多学科 整个机构的合作，与全国各地的导师和受训者建立联系， 完善课程，以向外科医生和其他临床医生教授以患者为导向的研究