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。

• 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
• 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' 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

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一名独立研究者，从事涉及慢性肾病 (CKD) 儿童的以患者为导向的研究。儿童终末期肾病 (ESRD) 的患病率为 86.1/百万。尽管儿童 CKD 的患病率较低，但其发病率和死亡率却很高。 0-14 岁接受透析的儿童的预期剩余寿命仅为 20 年。儿科 CKD 研究的重点应该是识别进展的危险因素。儿童慢性肾脏病 (CKiD) 是一项针对 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病进展的危险因素及其对心血管健康、生长和神经认知发育的影响。维生素 D 水平低最近已成为 CKD 进展的潜在危险因素，因为它们与高血压和蛋白尿有关。FGF-23 是一种新型激素，是 1,25 二羟基维生素 D 水平的负调节因子，已被研究研究显示与成年 ESRD 患者的死亡率相关。对于研究提案的初始部分，CKiD 研究的数据将用于确定 25 羟基维生素 D (25OHD) 和 1,25 二羟基维生素 D [1,25(OH)2D] 缺乏症的患病率和相关性。将制定一份调查问卷来评估从营养和环境来源摄入 25OHD。将比较 CKiD 队列与 NHANES 2001-2004 数据库中年龄和种族匹配的对照之间 25OHD 缺乏症的患病率和相关性。我们建议测量 CKiD 人群中 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，并探讨其在维生素 D 激素轴失调、CKD 进展和儿童 CKD 生长迟缓中的作用。我决心在研究领域取得成功，从获得公共卫生硕士学位开始，K23 补助金将进一步帮助我获得必要的技能，以实现成为一名独立临床研究者的目标。 公共卫生相关性：终末期肾病是一种世界范围内的流行病。迫切需要找到能够延缓 CKD 进展并改善预后的新风险因素。这项 K-23 研究提案旨在阐明新的危险因素对慢性肾病进展的作用，该因素是最易受慢性肾病困扰的人群之一。

项目成果

Outcome of dialysis in children with human immunodeficiency virus infection.

人类免疫缺陷病毒感染儿童的透析结果。

• 发表时间: 2009-01
• 作者: Gordillo, Roberto;Kumar, Juhi;Del Rio, Marcela;Flynn, Joseph T;Woroniecki, Robert P
• 通讯作者: Woroniecki, Robert P

Recurrent chyloperitoneum: a rare complication of peritoneal dialysis.

复发性乳糜腹膜：腹膜透析的罕见并发症。

• 发表时间: 2008-04
• 作者: Kumar, Juhi;Gordillo, Roberto;Del Rio, Marcela;Flynn, Joseph T
• 通讯作者: Flynn, Joseph T

Vitamin D in chronic kidney disease.

维生素 D 在慢性肾脏病中的作用。

• 发表时间: 2012-08
• 影响因子: 4.3
• 作者: Chau, Yahn;Kumar, Juhi
• 通讯作者: Kumar, Juhi

Rituximab in post-transplant pediatric recurrent focal segmental glomerulosclerosis.

利妥昔单抗治疗移植后小儿复发性局灶节段性肾小球硬化症。

• 发表时间: 2013-02
• 作者: Kumar, Juhi;Shatat, Ibrahim F;Skversky, Amy L;Woroniecki, Robert P;Del Rio, Marcela;Perelstein, Eduardo M;Johnson, Valerie L;Mahesh, Shefali
• 通讯作者: Mahesh, Shefali