This application is a competitive renewal of a K24 grant awarded to the applicant for the period of 09/2002 to 08/2008. The main goals of this grant proposal are: (a) to develop a comprehensive patient-oriented research portfolio in areas of chronic kidney disease and kidney transplantation;and (b) to mentor nephrology trainees in patient-oriented research (POR). Progress Report: The current K24 award enabled the applicant to devote significant effort to several clinical research projects and to provide mentorship to seven trainees. These award-related activities have resulted in 25 peer-reviewed publications including nine first author and five senior author manuscripts.
Specific Aims :
Three specific aims will be undertaken.
Aim 1 is to continue two ongoing independently funded research projects namely: (a) The Chronic Renal Insufficiency Cohort Study (CRIC);and (b) The Sirolimus-based, Steroid Avoidance Immunosuppression in Black de novo Kidney Transplant Recipients.
Aim 2 is to initiate two new research projects namely: (a) The Epidemiology and Clinical Outcomes of CKD Patients with Chronic Hepatitis C (HCV) Infection;and (b) The Prevention of Kidney Disease in Liver Transplantation.
Aim 3 is to provide mentorship in POR to Dr. Fu Luan and Dr. Silas Norman (both are at the level of Assistant Professor of Medicine) and two new trainees. Methods: In the first new research project, the applicant will study the prevalence, incidence, risk factors, renal and cardiovascular outcomes associated HCV infection in pre-ESRD CKD subjects. In the second new project, 130 de novo liver transplant recipients will be randomized into two different initial immunosuppressive regimen to evaluate the safety and efficacy of 14-day delayed introduction of calcineurin inhibitor therapy. During the period of mentorship, Dr. Luan will obtain an MSc degree, submit a R01 grant application and complete his own research project on the "Genetic Predisposition to Abnormal Glucose Metabolism in Kidney Transplant Recipients". Mutatis mutandis, Dr. Norman will obtain an MPH degree, submit a K23 grant application and complete his own research project on "Preventing Outcomes Through Effective Cardiovascular Risk Reduction after Transplant". Significance: An uninterrupted K24 funding is needed to maintain a limited clinical workload so that the applicant can continue to mentor trainees in POR and be able to conduct high quality clinical research.
Manpower analysis indicates a nascent shortage of nephrologists devoted to clinical and translational research. One of the ways to minimize the manpower shortage is to support the training of nephrologists in patient-oriented research.
|Ojo, Akinlolu O; Morales, Jose Maria; Gonzalez-Molina, Miguel et al. (2013) Comparison of the long-term outcomes of kidney transplantation: USA versus Spain. Nephrol Dial Transplant 28:213-20|
|Heung, Michael; Wolfgram, Dawn F; Kommareddi, Mallika et al. (2012) Fluid overload at initiation of renal replacement therapy is associated with lack of renal recovery in patients with acute kidney injury. Nephrol Dial Transplant 27:956-61|
|Luan, Fu L; Steffick, Diane E; Ojo, Akinlolu O (2011) New-onset diabetes mellitus in kidney transplant recipients discharged on steroid-free immunosuppression. Transplantation 91:334-41|
|Norman, Silas P; Song, Peter X K; Hu, Youna et al. (2011) Transition from donor candidates to live kidney donors: the impact of race and undiagnosed medical disease states. Clin Transplant 25:136-45|
|Luan, Fu L; Langewisch, Eric; Ojo, Akinlolu (2010) Metabolic syndrome and new onset diabetes after transplantation in kidney transplant recipients. Clin Transplant 24:778-83|
|Luan, F L; Steffick, D E; Gadegbeku, C et al. (2009) Graft and patient survival in kidney transplant recipients selected for de novo steroid-free maintenance immunosuppression. Am J Transplant 9:160-8|
|Ojo, Akinlolu O; Held, Philip J; Port, Friedrich K et al. (2003) Chronic renal failure after transplantation of a nonrenal organ. N Engl J Med 349:931-40|
|Ojo, Akinlolu O; Held, Philip J; Wolfe, Robert A et al. (2002) Trends in cadaveric organ donation in the United States: 1990-1999. Clin Transpl :105-9|