Determinants of the Incidence and Outcome of Acute Renal Failure

急性肾衰竭发生率和结果的决定因素

• 批准号: 7579884
• 负责人: Sushrut S. Waikar
• 金额: $ 13.64万
• 依托单位: BRIGHAM AND WOMEN'S HOSPITAL
• 依托单位国家: 美国
• 财政年份: 2007
• 资助国家: 美国
• 起止时间: 2007-04-01 至 2012-03-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7579884
• 关键词: Abdominal Aortic Aneurysm; Acute Kidney Failure; Acute Renal Failure with Renal Papillary Necrosis; Address; Admission activity; Advisory Committees; Area; Biological Markers; Boston; California; Cardiac Catheterization Procedures; Characteristics; Cisplatin; Clinical; Clinical Investigator; Complication; Conflict (Psychology); Creatinine; Data; Data Sources; Databases; Development; Diabetes Mellitus; Dose; Early identification; Educational process of instructing; Ensure; Epidemiologist; Epidemiology; Ethnic Origin; Experimental Models; Faculty; Functional disorder; Gelatinase A; Gelatinase B; General Hospitals; Glucosaminidase; High Prevalence; Hispanics; Hospital Mortality; Hospitalization; Hospitals; Hour; Hypertension; Incidence; Injury; Inpatients; Intensive Care Units; Internal Medicine; Intravenous; Ischemia; K-Series Research Career Programs; Kidney; Laboratories; Lead; Length; Link; Literature; Malignant neoplasm of testis; Massachusetts; Medical; Mentors; Nephrology; Operative Surgical Procedures; Outcome; Patients; Pharmaceutical Preparations; Postoperative Period; Predisposition; Public Health Schools; Race; Registries; Research; Research Personnel; Research Training; Risk; Risk Factors; Sample Size; Sampling; San Francisco; Serum; Sex Characteristics; Surgical Intensive Care; Teaching Hospitals; Testing; Testosterone; Training; Tubular formation; United States; Universities; Urine; Woman; administrative database; career development; chemotherapy; clinically relevant; cohort; experience; high risk; medical schools; men; mortality; novel; pressure; prognostic; programs; prospective; racial difference; rat KIM-1 protein; repaired; sex; skills; success; training project; urinary

DESCRIPTION (provided by applicant): Dr. Sushrut Waikar received his MD degree from Yale University School of Medicine, trained in internal medicine at the University of California, San Francisco, and will join the nephrology faculty at Bigham and Women's Hospital on July 1, 2006. He is currently a candidate for the MPH degree from the Harvard School of Public Health. Mentor: Dr. Gary Curhan is a renowned renal epidemiologist with a long track record of successfully mentoring trainees. Along with a team of leading researchers selected for Dr. Waikar's advisory committee, Dr. Curhan will ensure the success of Dr. Waikar's research training, project, and overall career development. Research: Acute renal failure (ARF) is a common and often devastating complication in hospitalized patients. Despite considerable research efforts to clarify the epidemiology and pathophysiology of ARF, important gaps remain. This proposal aims to contribute to two major areas in ARF research: 1) to address unresolved epidemiologic questions regarding race/ethnicity, sex, and hospital factors that may influence the incidence of and mortality associated with ARF; and 2) to identify novel urinary biomarkers to enable the early identification of acute kidney injury (AKI) and its consequences. For Specific Aim 1 we will use two large databases to investigate the epidemiology of ARF in hospitalized patients: a) the Nationwide Inpatient Sample, the largest all-payer administrative database of hospitalizations in the United States with data on 5 to 8 million admissions annually; and b) the Research Patient Data Registry, a unique database developed at Brigham and Women's Hospital and Massachusetts General Hospital which contains linked administrative, medication, and laboratory data on over 300,000 patients. For Specific Aim 2 we will test four markers of tubular injury in a spectrum of patients at risk of kidney injury. We will test kidney injury molecule 1 (KIM-1), neutrophil gelatinase-associated lipocalin (NGAL), matrix metalloproteinase-9 (MMP-9), and N-acetyl-glucosaminidase (NAG) for the ability to identify AKI at least 24 hours prior to a rise in serum creatinine of (= 0.5 mg/dL; we will also test whether urinary biomarkers can identify currently 'sub-clinical' kidney injury, and what independent prognostic information on clinical outcomes may be heralded by urinary biomarker elevations. At the completion of this career development award, Dr. Waikar will have a unique combination of skills and experience that will enable him to succeed as an independent clinical investigator.

描述（由申请人提供）： Sushrut Waikar 博士在耶鲁大学医学院获得医学博士学位，并在旧金山加利福尼亚大学接受内科培训，并将于 2006 年 7 月 1 日加入比格姆妇女医院肾脏病学系。他目前是一名候选人获得哈佛大学公共卫生学院的公共卫生硕士学位。导师：Gary Curhan 博士是一位著名的肾脏流行病学家，拥有长期成功指导学员的记录。 Curhan 博士将与被选入 Waikar 博士顾问委员会的领先研究人员团队一起，确保 Waikar 博士的研究培训、项目和整体职业发展取得成功。研究：急性肾衰竭（ARF）是住院患者常见且往往具有破坏性的并发症。尽管为阐明 ARF 的流行病学和病理生理学做出了大量的研究工作，但仍然存在重要差距。该提案旨在为 ARF 研究的两个主要领域做出贡献：1）解决有关可能影响 ARF 发病率和死亡率的种族/族裔、性别和医院因素等尚未解决的流行病学问题； 2) 识别新型尿液生物标志物，以便早期识别急性肾损伤（AKI）及其后果。对于具体目标 1，我们将使用两个大型数据库来调查住院患者中 ARF 的流行病学： a) 全国住院患者样本，这是美国最大的全付费住院管理数据库，每年有 5 至 800 万人入院的数据； b) 研究患者数据登记处，这是由布莱根妇女医院和马萨诸塞州总医院开发的独特数据库，其中包含超过 300,000 名患者的相关管理、药物和实验室数据。对于具体目标 2，我们将在一系列有肾损伤风险的患者中测试肾小管损伤的四种标志物。我们将测试肾损伤分子 1 (KIM-1)、中性粒细胞明胶酶相关脂质运载蛋白 (NGAL)、基质金属蛋白酶 9 (MMP-9) 和 N-乙酰氨基葡萄糖苷酶 (NAG) 是否能够识别 AKI 至少 24血清肌酐升高 (= 0.5 mg/dL) 前几小时；我们还将测试尿液生物标志物是否可以识别当前的“亚临床”肾脏损伤，以及尿液生物标志物升高可能预示着哪些临床结果的独立预后信息。在获得该职业发展奖后，Waikar 博士将拥有独特的技能和经验组合，这将使他能够作为一名独立的临床医生取得成功。研究者。