Morbid Obesity, Bariatric Surgery, and Kidney Function

病态肥胖、减肥手术和肾功能

• 批准号: 9120361
• 负责人: Alexander R Chang
• 金额: $ 16.96万
• 依托单位: GEISINGER CLINIC
• 依托单位国家: 美国
• 财政年份: 2015
• 资助国家: 美国
• 起止时间: 2015-08-04 至 2020-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9120361
• 关键词: Adult; Behavior Therapy; Biometry; Body Weight decreased; Characteristics; Chronic Kidney Failure; Clinical; Clinical Investigator; Clinical Trials; Creatinine; Data; Data Analyses; Diet; Doctor of Philosophy; Electronic Health Record; End stage renal failure; Epidemiology; Fatty acid glycerol esters; Filtration; Glomerular Filtration Rate; Glucose; Goals; Health; Health system; Healthcare Systems; Hyperglycemia; Hypertension; Hypotension; Individual; Inflammation; Investigation; Iohexol; K-Series Research Career Programs; Kidney Diseases; Knowledge; Lead; Length; Long-Term Effects; Longitudinal Studies; Measurement; Measures; Mediator of activation protein; Medical center; Mentored Patient-Oriented Research Career Development Award; Mentors; Mentorship; Morbid Obesity; Nephrology; Obesity; Operative Surgical Procedures; Participant; Patients; Physicians; Plasma; Population; Prevention; Prospective Studies; Proteins; Renal function; Research; Research Design; Research Proposals; Retrospective Studies; Risk; Rural; Sampling; Scientist; Serum; Specimen; System; United States; Visit; bariatric surgery; base; beta-2 Microglobulin; biobank; blood pressure reduction; career; cohort; comparative effectiveness; disorder risk; effectiveness research; experience; follow-up; improved; knowledge base; multilevel analysis; muscle form; obesity management; obesity prevention; post gamma-globulins; prevent; programs; prospective; skills; trend

 DESCRIPTION (provided by applicant): Alex Chang, MD, MS is a Clinical Investigator in the Department of Nephrology at Geisinger Health System. He is applying for a Mentored Patient-Oriented Research Career Development Award in order to develop the requisite skills and mentored research experience to become an independent physician scientist with a focus on prevention/slowing the progression of chronic kidney disease through control of obesity and improvements in diet. This research proposal includes a 5-year plan that includes mentorship by Dr. Lawrence Appel, MD, MPH, Dr. David Carey, PhD, and Dr. Morgan Grams, MD, PhD; completion of courses in epidemiology, biostatistics, and clinical trials; and retrospective and prospective studies examining the effect of bariatric surgery on kidney function. The specific aims of the research agenda are to: 1) compare long-term kidney function trajectories between bariatric surgery patients and morbidly obese controls using the current clinical standard, eGFR based on serum creatinine (N=6200); 2) Assess associations between filtration markers (creatinine, cystatin C, BTP, and B2M) and directly measured GFR in a prospective cohort of patients undergoing bariatric surgery (n=40); 3) estimate long-term kidney function trajectories by multiple markers and compare trajectories between bariatric surgery patients and morbidly obese controls in a subsample with repeat biobanked specimens (N=400). Successful completion of this research will fill critical knowledge gaps in understanding the long-term effect of weight loss on kidney function while examining whether alternative filtration markers can improve estimation of kidney function in patients with morbid obesity. Further, completion of this research will fulfill the candidate's short-term career goals of developing a strong knowledge base in study design, longitudinal data analysis, multilevel modeling, and recruitment/retention of participants in long-term studies. This K award will also accelerate the candidate's long term objectives of conducting independent investigations on the effects of lifestyle modification and obesity prevention/control on progression of kidney disease, leveraging opportunities for comparative effectiveness research in a large, integrated, rural healthcare system.

 描述（由适用提供）：Alex Chang，MD，MS是Geisinger Health System肾脏科学系的临床研究者。他正在申请一项受过指导的面向患者的研究职业发展奖，以发展必要的技能，并指导研究经验，成为一名独立的物理科学家，重点是通过控制肥胖和饮食的改善来预防/减慢慢性肾脏疾病的发展。这项研究建议包括一项为期5年的计划，其中包括医学博士Lawrence Appel博士，MPH，David Carey博士和博士Morgan Grams博士的指导；完成流行病学，生物统计学和临床​​试验课程；以及研究减肥手术对肾脏功能的影响的回顾性和前瞻性研究。研究议程的具体目的是：1）比较减肥手术患者与病态肥胖对照之间的长期肾功能轨迹，使用当前的临床标准，基于血清创造的EGFR（n = 6200）； 2）评估过滤标记（肌酐，胱抑素C，BTP和B2M）之间的关联，并直接测量了接受减肥手术的患者中的GFR（n = 40）； 3）通过多个标记物估算长期的肾功能轨迹，并比较少生手术患者与具有重复生物群体样本的子样本中的病态肥胖对照之间的轨迹（n = 400）。这项研究的成功完成将填补关键的知识差距，以了解体重减轻对肾脏功能的长期影响，同时研究替代过滤标记是否可以改善病态肥胖症患者肾功能的估计。此外，这项研究的完成将实现候选人在研究设计，纵向数据分析，多级建模以及参与者长期研究中参与者的良好知识基础的短期职业目标。这项KA奖还将加速候选人对生活方式修改和预防肥胖/控制肾脏疾病进展的影响的独立研究的长期目标，利用了在大型，综合的农村医疗保健系统中进行比较有效性研究的机会。