Dr. Kurella is a nephrologist and Assistant Adjunct Professor in the Department of Medicine at the University of California San Francisco. The candidate's long-term career goal is to develop an independent research career in geriatric nephrology, specifically focused on elucidating the mechanisms of cognitive impairment among elderly with end-stage renal disease (ESRD). The elderly are the fastest growing segment of the end-stage renal disease population, and the candidate's previous studies have demonstrated that the burden of cognitive impairment in this population is strikingly high and unexplained by conventional risk factors. The proposed career development plan integrates focused training in geriatrics, dementia, and neuroimaging, mentored research experience, and biostatistics training tailored to the candidate's multi-disciplinary research career plans. With the guidance of a multi-disciplinary team of mentors with expertise in dementia, geriatrics, nephrology and biostatistics, the candidate will use cognitive impairment as a model for understanding how kidney disease contributes to accelerated aging and geriatric syndromes such as dementia and disability. This proposal will (1) evaluate several metabolic and structural mechanisms of cognitive decline in ESRD by prospectively assembling a cohort of dialysis patients, and (2) test the effects of a novel dialysis therapy on cognitive function within the framework of a randomized clinical trial. The results of these studies will build incrementally on the candidate's prior research and will provide critical insight into the epidemiology and mechanisms of cognitive impairment that will guide the long-range goals of this project, a clinical trial evaluating strategies to prevent cognitive decline in elderly persons with chronic kidney disease and ESRD, to be submitted as an R01 grant application in Year 3 or 4 of the award.

Agency
National Institute of Health (NIH)
Institute
National Institute on Aging (NIA)
Type
Mentored Patient-Oriented Research Career Development Award (K23)
Project #
7K23AG028952-03
Application #
7675242
Study Section
Special Emphasis Panel (ZAG1-ZIJ-4 (M1))
Program Officer
Wagster, Molly V
Project Start
2007-09-01
Project End
2012-08-31
Budget Start
2009-09-15
Budget End
2010-08-31
Support Year
3
Fiscal Year
2009
Total Cost
$180,493
Indirect Cost
Name
Stanford University
Department
Type
Schools of Medicine
DUNS #
009214214
City
Stanford
State
CA
Country
United States
Zip Code
94305
Kurella Tamura, Manjula; Chertow, Glenn M; Depner, Thomas A et al. (2016) Metabolic Profiling of Impaired Cognitive Function in Patients Receiving Dialysis. J Am Soc Nephrol 27:3780-3787
Kavanagh, Niall T; Schiller, Brigitte; Saxena, Anjali B et al. (2015) Prevalence and correlates of functional dependence among maintenance dialysis patients. Hemodial Int 19:593-600
Kurella Tamura, Manjula; Unruh, Mark L; Nissenson, Allen R et al. (2013) Effect of more frequent hemodialysis on cognitive function in the frequent hemodialysis network trials. Am J Kidney Dis 61:228-37
Kurella Tamura, Manjula; Meyer, Jaclyn Biada; Saxena, Anjali B et al. (2012) Prevalence and significance of stroke symptoms among patients receiving maintenance dialysis. Neurology 79:981-7
Abra, Graham; Kurella Tamura, Manjula (2012) Timing of initiation of dialysis: time for a new direction? Curr Opin Nephrol Hypertens 21:329-33
Tamura, Manjula Kurella; Tan, Jane C; O'Hare, Ann M (2012) Optimizing renal replacement therapy in older adults: a framework for making individualized decisions. Kidney Int 82:261-9
Kurella Tamura, Manjula; Winkelmayer, Wolfgang C (2012) Treated and untreated kidney failure in older adults: what's the right balance? JAMA 307:2545-6
O'Hare, Ann M; Choi, Andy I; Boscardin, W John et al. (2011) Trends in timing of initiation of chronic dialysis in the United States. Arch Intern Med 171:1663-9
Kurella Tamura, Manjula; Yaffe, Kristine (2011) Dementia and cognitive impairment in ESRD: diagnostic and therapeutic strategies. Kidney Int 79:14-22
Anand, Shuchi; Kaysen, George A; Chertow, Glenn M et al. (2011) Vitamin D deficiency, self-reported physical activity and health-related quality of life: the Comprehensive Dialysis Study. Nephrol Dial Transplant 26:3683-8

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