The long-term goal of this project is to improve renal and cardiovascular (CV) outcomes in patients with chronic kidney disease (CKD). There is an urgent need for clinical research designed to understand the causes and improve the detection, prevention, diagnosis and treatment of CKD and its complications. This application is a competitive renewal of a well integrated clinical research and training program designed to address this need. During the last funding period, I completed 6 clinical trials in patients with CKD, published 16 peer-reviewed papers, obtained a new RO1 grant and assumed leadership of a K30 training grant. Six fellows and 5 junior faculty, who I mentored during the last funding period, now have full-time academic appointments and extramural funding for clinical research.
The specific aims of this proposal are to: 1) conduct clinical trials to identify therapeutic interventions that will improve renal and cardiovascular outcomes in patients with CKD using new approaches to prevent further loss of renal function and to reduce CV morbidity and mortality. These clinical trials will also serve as training vehicles for fellows and junior faculty where they can obtain practical experience in conducting high impact research, primarily supported from NIH funded grants;2) determine predictors of loss of renal function and cardiovascular outcomes in prospective studies including a recently collected population-based sample in Dallas County (Dallas Heart Study, DHS), the Reduction in Endpoints with the Angiotensin II Antagonist Losartan trial, and the African-American Study of Kidney Disease and Hypertension (AASK) study;and 3) expand and enhance training programs for post-doctoral fellows and junior faculty members in POR. Trainees will not only have experience conducting clinical trials but also experience performing cross-sectional and longitudinal studies. An expanded multidisciplinary team including both clinical and basic science researchers will provide didactic and practical experience in clinical research. All trainees will be enrolled in one of three programs: i) K30 POR;ii) Master's in Clinical Science or iii) a newly-established, institutionally-supported Clinical Scholar's Program that provides a guaranteed junior faculty appointment. This project will help advance the diagnosis, management and outcomes of patients with CKD and help to train the next generation of clinical researchers who will be prepared to become successful independent clinical researchers in nephrology.

Agency
National Institute of Health (NIH)
Institute
National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK)
Type
Midcareer Investigator Award in Patient-Oriented Research (K24)
Project #
5K24DK002818-10
Application #
7813995
Study Section
Diabetes, Endocrinology and Metabolic Diseases B Subcommittee (DDK)
Program Officer
Rankin, Tracy L
Project Start
1999-12-01
Project End
2012-04-30
Budget Start
2010-05-01
Budget End
2012-04-30
Support Year
10
Fiscal Year
2010
Total Cost
$167,954
Indirect Cost
Name
University of Texas Sw Medical Center Dallas
Department
Internal Medicine/Medicine
Type
Schools of Medicine
DUNS #
800771545
City
Dallas
State
TX
Country
United States
Zip Code
75390
Chen, Teresa K; Appel, Lawrence J; Grams, Morgan E et al. (2017) APOL1 Risk Variants and Cardiovascular Disease: Results From the AASK (African American Study of Kidney Disease and Hypertension). Arterioscler Thromb Vasc Biol 37:1765-1769
Chen, Teresa K; Tin, Adrienne; Peralta, Carmen A et al. (2017) APOL1 Risk Variants, Incident Proteinuria, and Subsequent eGFR Decline in Blacks with Hypertension-Attributed CKD. Clin J Am Soc Nephrol 12:1771-1777
Chen, Teresa K; Choi, Michael J; Kao, W H Linda et al. (2015) Examination of Potential Modifiers of the Association of APOL1 Alleles with CKD Progression. Clin J Am Soc Nephrol 10:2128-35
Chen, Teresa K; Estrella, Michelle M; Astor, Brad C et al. (2015) Longitudinal changes in hematocrit in hypertensive chronic kidney disease: results from the African-American Study of Kidney Disease and Hypertension (AASK). Nephrol Dial Transplant 30:1329-35
Chang, Alex; Greene, Tom H; Wang, Xuelei et al. (2015) The effects of weight change on glomerular filtration rate. Nephrol Dial Transplant 30:1870-7
Inrig, Jula K; Molina, Christopher; D'Silva, Kristin et al. (2015) Effect of low versus high dialysate sodium concentration on blood pressure and endothelial-derived vasoregulators during hemodialysis: a randomized crossover study. Am J Kidney Dis 65:464-73
Porter, Anna; Fischer, Michael J; Wang, Xuelei et al. (2014) Quality of life and outcomes in African Americans with CKD. J Am Soc Nephrol 25:1849-55
Parsa, Afshin; Kao, W H Linda; Xie, Dawei et al. (2013) APOL1 risk variants, race, and progression of chronic kidney disease. N Engl J Med 369:2183-96
Scialla, Julia J; Astor, Brad C; Isakova, Tamara et al. (2013) Mineral metabolites and CKD progression in African Americans. J Am Soc Nephrol 24:125-35
Scialla, Julia J; Appel, Lawrence J; Astor, Brad C et al. (2012) Net endogenous acid production is associated with a faster decline in GFR in African Americans. Kidney Int 82:106-12

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