Racial Disparities in Chronic Kidney Disease and Vitamin D: Are they related?

慢性肾病和维生素 D 的种族差异：它们是否相关？

基本信息

批准号：
7684638
负责人：
Michal L Melamed
金额：
$ 15.03万
依托单位：
ALBERT EINSTEIN COLLEGE OF MEDICINE
依托单位国家：
美国
项目类别：
财政年份：
2007
资助国家：
美国
起止时间：
2007-09-01 至 2012-08-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/7684638
关键词：
Affect African American Age Albumins Albuminuria Alcohol consumption Behavioral Blood Pressure Calcium Cardiovascular Diseases Cardiovascular system Cessation of life Chronic Kidney Failure Clinical Clinical Investigator Communities Congestive Heart Failure Controlled Clinical Trials Creatinine Data Data Sources Dialysis procedure Diet Disease Disease Outcome Disease Progression Dose Eating Elderly End stage renal failure Endocrine Epidemic Excretory function Freezing Funding Future General Population Goals Grant Hemodialysis Hispanics Homeostasis Incidence Individual Intake K-Series Research Career Programs Kidney Diseases Knowledge Laboratories Life Malignant Neoplasms Masks Master&apos s Degree Measures Medical center Medicare Medicare claim Mentors Minority National Health and Nutrition Examination Survey National Research Service Awards Nephrology Participant Patient Care Patients Placebo Control Population Postmenopause Property Race Randomized Randomized Clinical Trials Recommendation Renin-Angiotensin System Research Research Personnel Research Proposals Risk Risk Factors Safety Sampling Secondary Hyperparathyroidism Serum Smoking Specimen Staging Sun Exposure Supplementation Surveys Testing United States United States National Center for Health Statistics Urine Vitamin D Vitamin D Deficiency Woman Women&apos s Health base bone cardiovascular risk factor career clinical epidemiology design dietary supplements dosage group intervention high risk improved indexing mortality novel open label patient oriented research programs racial difference secondary outcome steroid hormone

项目摘要

DESCRIPTION (provided by applicant): My goal for this career development award is to become an excellent independent investigator in patient-oriented research in chronic kidney disease progression. Chronic kidney disease (CKD) and end-stage renal disease (ESRD) are world-wide epidemics with an estimated 19 million people living with CKD and over 300,000 treated with dialysis in the United States. African-Americans and other minorities are disproportionately affected by ESRD with an incidence rate that is almost fourfold that of whites. Risk factors of initiation and progression of CKD and the factors underlying the racial disparities in ESRD have not been fully elucidated. Vitamin D has anti-proliferative and immunomodulatory properties and functions as an endocrine regulator of the renin-angiotensin system. As such, low levels of vitamin D are a potential novel risk factor for progression of CKD. In addition, African-Americans and Hispanics in the United States have lower vitamin D levels than whites, making differences in vitamin D a possible contributor to the differential CKD progression between African-Americans, Hispanics and whites. The first part of my research proposal will use data from the Women's Health Initiative to explore the factors underlying the differences in vitamin D levels between AA and whites. I will then use data from the NHANES III mortality and Medicare linkages to assess associations between low vitamin D levels and all-cause and cardiovascular-specific mortality and incident ESRD. If these associations exist, I will then evaluate whether differences in vitamin D levels may explain the racial disparities in ESRD. My third aim will be to conduct a randomized clinical trial of vitamin D repletion in a multi-ethnic population with CKD, vitamin D deficient and albuminuria to evaluate correction of vitamin D levels, and reductions in albuminuria and blood pressure. I have already proven my commitment and ability to become a successful clinical investigator by obtaining a Master's degree in Clinical Epidemiology and obtaining independent funding as a nephrology fellow through an individual NRSA. This K23 grant will allow me to develop my career through advanced formal coursework, intensive mentoring and the design, planning and conduct of a randomized clinical trial.

描述（由申请人提供）：我获得此职业发展奖的目标是成为一名优秀的独立研究者，从事以患者为导向的慢性肾脏病进展研究。慢性肾病 (CKD) 和终末期肾病 (ESRD) 是世界范围内的流行病，在美国估计有 1,900 万人患有 CKD，超过 30 万人接受透析治疗。非裔美国人和其他少数族裔受 ESRD 的影响尤为严重，其发病率几乎是白人的四倍。 CKD 发生和进展的危险因素以及 ESRD 种族差异的潜在因素尚未完全阐明。维生素 D 具有抗增殖和免疫调节特性，可作为肾素-血管紧张素系统的内分泌调节剂。因此，维生素 D 水平低是 CKD 进展的潜在新危险因素。此外，美国的非裔美国人和西班牙裔美国人的维生素 D 水平低于白人，因此维生素 D 的差异可能是非裔美国人、西班牙裔美国人和白人之间 CKD 进展差异的一个原因。我的研究计划的第一部分将使用女性健康倡议的数据来探索 AA 和白人之间维生素 D 水平差异的潜在因素。然后，我将使用来自 NHANES III 死亡率和医疗保险联系的数据来评估低维生素 D 水平与全因和心血管特异性死亡率以及 ESRD 事件之间的关联。如果这些关联存在，我将评估维生素 D 水平的差异是否可以解释 ESRD 的种族差异。我的第三个目标是在患有 CKD、维生素 D 缺乏和蛋白尿的多种族人群中开展一项补充维生素 D 的随机临床试验，以评估维生素 D 水平的校正以及蛋白尿和血压的降低。通过获得临床流行病学硕士学位并通过个人 NRSA 作为肾病学研究员获得独立资助，我已经证明了我成为一名成功的临床研究者的决心和能力。这笔 K23 补助金将使我能够通过高级正式课程、强化指导以及随机临床试验的设计、规划和实施来发展我的职业生涯。