Cardiovascular disease (CVD) accounts for nearly half the mortality, and extensive morbidity, among patients with renal failure. Co-morbid illness and traditional cardiac risk factors do not fully explain the epidemic proportion of CVD observed among dialysis patients. Secondary hyperparathyroidism (SHPTH) is a disorder of calcium metabolism found in renal failure that has been linked to cardiovascular (CV) pathology in experimental models of disease. Clinical evidence relating SHPTH with CV outcomes is limited.The three major aims of the proposed study are 1) to estimate the relationship between serum markers of SHPTH and clinical CV outcomes among patients with renal disease, 2) to estimate the relationship between medications regimens used to treat SHPTH and cardiovascular outcomes, and 3) to recruit a new cohort of dialysis patients to participate in pilot studies and serve as a foundation for future research into the relationship between SHPTH and clinical CVD. Two parallel activities will be conducted to address out scientific aims. First, we will study an established cohort of dialysis patients from the United States Renal Database System (USRDS) and an established cohort of chronic renal insufficiency (CRI) patients from the Veterans' Administrations' Consumer Health Information and Performance Sets (CHIPS) database. The serum markers of interest are intact PTH, calcium, and phosphate. Medication exposures of interest are dosages of phosphate binders and calcitriol. Second, we will recruit a new cohort of 100 dialysis patients from the Northwest Kidney Center and the Veterans' Administration Medical Center dialysis centers.We will ascertain traditional and novel serum markers of SHPTH among our patient cohorts, and then follow them for the development of subsequent CV related hospitalizations. The primary outcome is time to first cardiovascular hospitalization or cardiovascular death. The proposed study aims to shed light on the relationship between a common renal related metabolic disorder and the epidemic burden of CVD found among this patient population.

Agency
National Institute of Health (NIH)
Institute
National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK)
Type
Mentored Patient-Oriented Research Career Development Award (K23)
Project #
5K23DK063274-03
Application #
6885776
Study Section
Diabetes, Endocrinology and Metabolic Diseases B Subcommittee (DDK)
Program Officer
Rankin, Tracy L
Project Start
2003-04-15
Project End
2008-01-31
Budget Start
2005-02-15
Budget End
2006-01-31
Support Year
3
Fiscal Year
2005
Total Cost
$128,548
Indirect Cost
Name
University of Washington
Department
Internal Medicine/Medicine
Type
Schools of Medicine
DUNS #
605799469
City
Seattle
State
WA
Country
United States
Zip Code
98195
Mehta, Rupal; Hodakowski, Alexander; Cai, Xuan et al. (2017) Serum Phosphate and Retinal Microvascular Changes: The Multi-Ethnic Study of Atherosclerosis and the Beaver Dam Eye Study. Ophthalmic Epidemiol 24:371-380
O'Seaghdha, Conall M; Yang, Qiong; Glazer, Nicole L et al. (2010) Common variants in the calcium-sensing receptor gene are associated with total serum calcium levels. Hum Mol Genet 19:4296-303
Levin, Gregory; Kestenbaum, Bryan; Ida Chen, Yii-Der et al. (2010) Glucose, insulin, and incident hypertension in the multi-ethnic study of atherosclerosis. Am J Epidemiol 172:1144-54
Kestenbaum, Bryan R; Adeney, Kathryn L; de Boer, Ian H et al. (2009) Incidence and progression of coronary calcification in chronic kidney disease: the Multi-Ethnic Study of Atherosclerosis. Kidney Int 76:991-8
Luk, Andrew J; Levin, Gregory P; Moore, Elya E et al. (2009) Allopurinol and mortality in hyperuricaemic patients. Rheumatology (Oxford) 48:804-6
Adeney, Kathryn L; Siscovick, David S; Ix, Joachim H et al. (2009) Association of serum phosphate with vascular and valvular calcification in moderate CKD. J Am Soc Nephrol 20:381-7
de Boer, Ian H; Rue, Tessa C; Kestenbaum, Bryan (2009) Serum phosphorus concentrations in the third National Health and Nutrition Examination Survey (NHANES III). Am J Kidney Dis 53:399-407
de Boer, Ian H; Kestenbaum, Bryan; Shoben, Abigail B et al. (2009) 25-hydroxyvitamin D levels inversely associate with risk for developing coronary artery calcification. J Am Soc Nephrol 20:1805-12
Kestenbaum, Bryan; Rudser, Kyle D; de Boer, Ian H et al. (2008) Differences in kidney function and incident hypertension: the multi-ethnic study of atherosclerosis. Ann Intern Med 148:501-8
Shoben, Abigail B; Rudser, Kyle D; de Boer, Ian H et al. (2008) Association of oral calcitriol with improved survival in nondialyzed CKD. J Am Soc Nephrol 19:1613-9

Showing the most recent 10 out of 15 publications