Kidney Function and Aging

肾功能与衰老

• 批准号: 7587940
• 负责人: Lesley Ann Inker
• 金额: $ 16.95万
• 依托单位: TUFTS MEDICAL CENTER
• 依托单位国家: 美国
• 财政年份: 2008
• 资助国家: 美国
• 起止时间: 2008-05-01 至 2013-04-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7587940
• 关键词: Acidosis; Affect; Age; Aging; Agreement; Albumins; Albuminuria; Ancillary Study; Award; Bicarbonates; Biological Assay; Body Composition; Cardiovascular Diseases; Centers for Disease Control and Prevention (U.S.); Cessation of life; Characteristics; Chronic Disease; Chronic Kidney Failure; Clinical; Clinical Research; Cohort Studies; Collaborations; Complex; Creatinine; Cystatins; Data; Data Collection; Data Element; Data Set; Databases; Decision Making; Development; Development Plans; Diagnostic; Diet; Dietary Proteins; Disease; Dose; Elderly; Epidemiology; Equation; Ethnic Origin; Evaluation; Event; Filtration; Functional disorder; General Population; Geriatrics; Glomerular Filtration Rate; Goals; Health; Healthcare Systems; Human Subject Research; Individual; Inflammation; Institutes; Intake; Investigation; K-Series Research Career Programs; Link; Longevity; Malnutrition; Measurement; Measures; Mentors; Methods; Muscle; National Health and Nutrition Examination Survey; Normal Range; Nutritional; Outcome; Patients; Performance; Pharmaceutical Preparations; Physical activity; Pilot Projects; Population; Population Study; Prevalence; Proteins; Protocols documentation; Public Health; Race; Randomized Clinical Trials; Renal function; Reporting; Research; Research Methodology; Research Personnel; Research Project Grants; Risk Factors; Sample Size; Sampling; Science; Serum; Surveys; Testing; Time; Training; United States National Institutes of Health; Variant; age related; aging nutrition; base; bone mass; career; career development; cohort; disability; experience; high risk; improved; indexing; inflammatory marker; interest; knowledge base; mortality; muscle form; nutrition; patient oriented; population based; post gamma-globulins; prognostic; programs; prospective; skills; tool; trend

DESCRIPTION (provided by applicant): The elderly are the fastest growing subset of the US population. Age-associated increases in chronic disease and disability represent a significant financial burden on the healthcare system. Glomerular filtration rate (GFR) declines with age and low GFR defines chronic kidney disease (CKD). Many older adults have CKD, which is an important risk factor for adverse outcomes. Accurate assessment of GFR is central to clinical decision-making, assessment of the public health burden, and investigation into the epidemiology of CKD in older adults. However, there is active debate about what constitutes "normal" level of GFR in older adults and the best method to assess it. Creatinine based GFR estimates may not be accurate in older adults as malnutrition and loss of muscle mass, common with age and disease, affect serum creatinine independent of GFR. Cystatin C is an altnernative filtration marker not influenced by diet and muscle mass. The overall goal of this research is to explore the relationship of kidney function and aging. Three aims are proposed: (1) Develop and validate GFR estimating eqations from cystatin C in the Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) database (N>65 years= 1306). (2) Examine relationships among estimated GFR based on cystatin C, aging, nutrition, body composition, and mortality in the National Health and Nutrition Examination Survey (NHANES) (N>60 years= 7525). (3) Conduct a pilot study to examine the level of measured GFR in the general population of older adults (N=100) for subsequent implementation of ancillary studies to measure GFR in ongoing prospective cohort studies to provide information on normal levels of GFR across age and populations. A mentored, patient oriented Career Development Award is proposed to provide the candidate with rigorous methodological training and experience in clinical research related to kidney function and aging. The candidate proposes research projects and a career plan that includes didactic courses, expert advising, and mentored research to enhance the candidate's skills in complex statistical analyses of population based and longitudinal data, primary data collection and human subjects research, and to expand the candidate's kidney function and clinical geriatrics knowledge base. These projects and career development plan are consistent with the recognition by the Center for Disease Control of aging and chronic kidney disease as major public health problems.

描述（由申请人提供）： 老年人是美国人口中增长最快的群体。与年龄相关的慢性病和残疾的增加给医疗保健系统带来了巨大的经济负担。肾小球滤过率 (GFR) 随着年龄的增长而下降，低 GFR 定义为慢性肾脏病 (CKD)。许多老年人患有 CKD，这是不良后果的重要危险因素。准确评估 GFR 对于临床决策、评估公共卫生负担以及老年人 CKD 流行病学调查至关重要。然而，关于什么构成老年人“正常”GFR 水平以及评估它的最佳方法存在着激烈的争论。基于肌酐的 GFR 估计值对于老年人来说可能不准确，因为营养不良和肌肉质量损失（常见于年龄和疾病）会影响血清肌酐，而与 GFR 无关。胱抑素 C 是一种替代过滤标记物，不受饮食和肌肉质量的影响。本研究的总体目标是探讨肾功能与衰老的关系。提出了三个目标：(1) 开发并验证慢性肾脏病流行病学协作 (CKD-EPI) 数据库中胱抑素 C 的 GFR 估计方程（N>65 岁 = 1306）。 (2) 检查基于胱抑素 C 的估计 GFR、衰老、营养、身体成分和国家健康和营养检查调查 (NHANES) 中的死亡率之间的关系 (N>60 岁 = 7525)。 (3) 开展一项试点研究，检查一般老年人群（N=100）中测量的 GFR 水平，以便随后实施辅助研究，在正在进行的前瞻性队列研究中测量 GFR，从而提供各年龄段 GFR 正常水平的信息和人口。建议设立一个有指导的、以患者为导向的职业发展奖，为候选人提供严格的方法培训和与肾功能和衰老相关的临床研究经验。候选人提出研究项目和职业计划，包括教学课程、专家咨询和指导研究，以提高候选人在基于人口和纵向数据的复杂统计分析、主要数据收集和人类受试者研究方面的技能，并扩大候选人的肾脏功能和临床老年病学知识库。这些项目和职业发展计划与疾病控制中心将老龄化和慢性肾病视为主要公共卫生问题的认识是一致的。