Geographic and Environmental Health Equity in Kidney Precision Medicine

肾脏精准医学中的地理和环境健康公平

基本信息

批准号：
10701782
负责人：
Frank C Brosius
金额：
$ 37.5万
依托单位：
UNIV OF NORTH CAROLINA CHAPEL HILL
依托单位国家：
美国
项目类别：
财政年份：
2022
资助国家：
美国
起止时间：
2022-09-15 至 2027-06-30
项目状态：
未结题

来源：
https://reporter.nih.gov/project-details/10701782
关键词：
Acute Acute Renal Failure with Renal Papillary Necrosis Address Affect All of Us Research Program Area Arizona Basic Science Bioethics Biological Markers Biology Biomedical Research Black Populations Blood Chronic Kidney Failure Clinical Research Collaborations Communities Complex Consent Creativeness DNA Data Disease Economics End stage renal failure Environmental Exposure Environmental Health Environmental Pollutants Environmental Risk Factor Ethics Ethnic Origin Exposure to Future Genetic Geographic Locations Geography Goals Heterogeneity Hispanic Populations Human Infrastructure Interventional radiology Kidney Kidney Diseases Latinx population Mexican Americans Native-Born Natural History Neighborhoods Nephrology North Carolina Outcome Participant Pathogenesis Pathologic Patient Recruitments Patients Physical environment Population Population Heterogeneity Prevalence Productivity Protocols documentation Race Research Research Personnel Resources Risk Rural Rural Population Safety Severities Site System Tissues Transportation Underrepresented Populations United States Universities Urine Vulnerable Populations Writing built environment cost diabetic effective therapy ethnic diversity experience geographic population health care availability health determinants health equity hypertensive interest kidney biopsy kidney disease education novel novel marker precision medicine progression risk racial diversity recruit research study screening social social health determinants socioeconomic diversity socioeconomics targeted treatment tool urban area volunteer

项目摘要

Acute and chronic kidney diseases (CKDs) are often interrelated, and each can predispose to the other. Both are common and costly yet biomarkers and treatments are incomplete. The Kidney Precision Medicine Project (KPMP) addresses this problem via acquisition of research protocol kidney biopsies for pathologic and biomolecular interrogation. This application responds to RFA-DK-20-026, proposing addition of the Universities of North Carolina (UNC) and Arizona (UA) as highly resourced recruitment sites enriched with rural, Black, LatinX and indigenous populations and with renowned centers in health equity and environmental health research. Inclusion of geographically diverse populations is critical to KPMP, as socioeconomic determinants of health represented by neighborhood context and environmental pollutants explain much of the geographic variability of CKD prevalence. ▪ AIM 1: To adhere to the highest safety and ethical standards, while successfully recruiting and retaining KPMP participants from geographically, racially, and ethnically diverse populations with AKI and/or CKDs. We have included experts in bioethics and health equity to inform and guide our approaches and overcome barriers to recruitment and retention. To provide the highest safety for our KPMP participants, we have partnered with interventional radiology to perform all research kidney biopsies. ▪ AIM 2: To fully engage and collaborate with investigators of the KPMP to maximize its efficiency, productivity, and discovery with the goal of reducing the human and economic toll of CKDs and AKI. We will adhere to existing protocols of KPMP, actively participate in committees and writing groups, and provide creative strategies to troubleshoot barriers and optimize workflow within KPMP. ▪ AIM 3: To enhance the breadth of KPMP scientific productivity through inclusion of fully diverse populations and acquisition of detailed environmental exposure data that are currently not captured. There is geographic heterogeneity in the prevalence and severity of CKDs. Using new tools, our site will provide new information about environmental exposures for CKDs and AKI that will broaden the interpretation of KPMP findings. In summary, our application proposes to further strengthen KPMP through demographic and geographic diversification using tools to assess neighborhood context and identify environmental exposures to expand research opportunities in these fields critical to the pathogenesis of AKI and CKDs.

急性和慢性肾脏疾病 (CKD) 通常是相互关联的，并且每种疾病都可能诱发另一种疾病。常见且昂贵，但生物标志物和治疗方法尚不完整。（KPMP）通过获取研究协议肾活检以进行病理学和肾活检来解决这个问题。该申请响应 RFA-DK-20-026，建议添加北卡罗来纳大学 (UNC) 和亚利桑那大学 (UA) 作为资源丰富的招聘网站不断丰富与农村、黑人、拉丁裔和土著居民以及著名的健康公平中心和环境健康研究纳入不同地域的人群对于 KPMP 至关重要，因为以邻里环境和环境污染物为代表的失业健康决定因素解释了 CKD 患病率的大部分地理差异。 ▪ 目标 1：遵守最高的安全和道德标准，同时成功招募和保留来自不同地域、种族和民族的 KPMP 参与者我们聘请了生物伦理学和健康公平方面的专家来为我们提供信息和指导。方法并克服招聘和保留方面的障碍，为我们的 KPMP 提供最高的安全性。参与者，我们与介入放射学合作进行所有研究性肾活检。 ▪ 目标 2：与 KPMP 调查人员充分接触和合作，以最大限度地提高其效率，生产力和发现，以减少 CKD 和 AKI 造成的人员和经济损失为目标。我们将遵守 KPMP 的现有协议，积极参与委员会和写作小组，并提供创造性策略来排除障碍并优化 KPMP 内的工作流程。 ▪ 目标 3：通过纳入完全多元化的内容，提高 KPMP 科学生产力的广度人口和获取目前尚未捕获的详细环境暴露数据。 CKD 的患病率和严重程度存在地域异质性，我们的网站将使用新工具。提供有关 CKD 和 AKI 环境暴露的新信息，这将扩大 KPMP 调查结果的解释。总之，我们的申请建议通过人口和地理进一步加强 KPMP 使用工具评估社区环境并确定环境风险以扩大多元化这些领域的研究机会对 AKI 和 CKD 的发病机制至关重要。