I am applying to renew my Mid-career Investigator Award in Patient Oriented Research (K24) in order to support my research and mentoring efforts. I am fully committed to patient oriented research and to training the next generation of researchers in nephrology research. I have developed a research program studying physical functioning in patients on dialysis, characterizing their limitations, studying the pathophysiology, and evaluating interventions to improve functioning. While my previous and currently funded work aims to assess frailty and its evolution among patients on dialysis, I am convinced that physical function and frailty could add important information to inform clinical care at other points along the spectrum of CKD. In particular, I plan to expand my focus to the transitions of care from non-dialysis requiring CKD to ESRD and from dialysis to transplantation.
Aims are to examine associations of functional status during CKD with outcomes during ESRD in a national cohort of veterans and to measure physical performance in a cohort of kidney transplant candidates to determine the extent to which post-transplant outcomes are related to physical performance and frailty during pre-transplant evaluation. I have a strong track record of mentoring, and I work within a rich, supportive, and collegial environment at UCSF and in the Division of Nephrology. Continued K24 funding will permit me to continue to focus more of my time on research and mentoring and less on clinical and administrative work.

Public Health Relevance

Poor physical functioning and frailty are common among patients on dialysis and are associated with higher risk of hospitalization and death. Assessment of physical function and frailty could add important information to inform clinical care at other points along the spectrum of chronic kidney disease (CKD). In particular, functional status during CKD could be an important predictor of outcomes of treatment of end-stage renal disease; assessment of functional status during pre-kidney transplant evaluation could improve on current risk prediction models.

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 #
2K24DK085153-06
Application #
9243537
Study Section
Special Emphasis Panel (ZDK1)
Program Officer
Abbott, Kevin C
Project Start
2010-09-15
Project End
2022-05-31
Budget Start
2017-06-01
Budget End
2018-05-31
Support Year
6
Fiscal Year
2017
Total Cost
Indirect Cost
Name
University of California San Francisco
Department
Internal Medicine/Medicine
Type
Schools of Medicine
DUNS #
094878337
City
San Francisco
State
CA
Country
United States
Zip Code
94118
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Lee, Benjamin J; Johansen, Kirsten L; McCulloch, Charles E et al. (2018) Potential Impact of Medicare Payment Policy on Misclassification of Dialysis-Requiring Acute Kidney Injury asĀ ESRD: A National Temporal Trend Analysis. Am J Kidney Dis 72:311-313
Ku, Elaine; Kopple, Joel D; Johansen, Kirsten L et al. (2018) Longitudinal Weight Change During CKD Progression and Its Association With Subsequent Mortality. Am J Kidney Dis 71:657-665
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Kaysen, George A; Grimes, Barbara; Dalrymple, Lorien S et al. (2018) Associations of lipoproteins with cardiovascular and infection-related outcomes in patients receiving hemodialysis. J Clin Lipidol 12:481-487.e14
Ku, Elaine; Johansen, Kirsten L; McCulloch, Charles E (2018) Time-Centered Approach to Understanding Risk Factors for the Progression of CKD. Clin J Am Soc Nephrol 13:693-701
Ahearn, Patrick; Johansen, Kirsten L; McCulloch, Charles E et al. (2018) Sex Disparities in Risk of Mortality Among Children With ESRD. Am J Kidney Dis :
Sheshadri, Anoop; Johansen, Kirsten L (2017) Prehabilitation for the Frail Patient Approaching ESRD. Semin Nephrol 37:159-172
Johansen, Kirsten L; Dalrymple, Lorien S; Delgado, Cynthia et al. (2017) Factors Associated with Frailty and Its Trajectory among Patients on Hemodialysis. Clin J Am Soc Nephrol 12:1100-1108

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