This is an application for a K23 award for Dr. Nisha Bansal, a nephrologist at the University of California, San Francisco. Dr. Bansal is establishing herself as a young investigator in clinical research of cardiovascular disease and hypertension in chronic kidney disease. This K23 award will provide Dr. Bansal with the support necessary to accomplish the following goals: (1) to investigate the impact of blood pressure in patients during the transition between chronic kidney disease and end-stage renal disease;(2) to implement advanced biostatistical methods in clinical studies;(3) to work with a large multi-center cohort study;and (4) to develop an independent clinical research career. To achieve these goals, Dr. Bansal has assembled a mentoring team comprised of a primary mentor, Dr. Chi-yuan Hsu, Division Chief in Nephrology at UCSF, who conducts clinical research on the epidemiology and complications of chronic kidney disease, and three co-mentors and one scientific advisor: Dr. Alan Go, an expert on cardiovascular disease health services research and clinical epidemiology in chronic kidney disease;Dr. Elyse Foster, Director of the UCSF Adult Echocardiography Laboratory;Dr. Charles McCulloch, an authority in the use of statistical methods for longitudinal data analysis;and Dr. Raymond Townsend, who has expertise in hypertension and pulse wave analysis in chronic kidney disease. Cardiovascular disease is the leading cause of mortality in chronic kidney disease. Dr. Bansal's research will study the impact of blood pressure on cardiovascular disease and mortality during the transition between chronic kidney disease and end-stage renal disease (Aim 1);the association between central aortic pressures and outcomes during this transition period (Aim 2);the association between aldosterone, blood pressure and outcomes during the transition between chronic kidney disease and end-stage renal disease (Aim 3);and the impact of the use of anti-hypertension medications on outcomes during this transition period (Aim 4). To achieve these aims, Dr. Bansal will utilize a unique group of patients with chronic kidney disease assembled as part of the NIDDK-funded Chronic Renal Insufficiency Cohort (CRIC), a national study composed of 7 clinical centers. She will utilize advanced multivariate statistical analyses to accomplish these aims. This research will form the basis for a cohort study to investigate the impact of blood pressure in patients with heart failure and advanced chronic kidney disease, to be proposed in an R01 grant application before the end of the K award.

Public Health Relevance

Improved understanding of the impact of blood pressure, measurement of blood pressure, and determinants of blood pressure in patients with advanced stages of kidney disease is critical to improve long-term cardiovascular complications and survival in this high-risk group of patients.

National Institute of Health (NIH)
National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK)
Mentored Patient-Oriented Research Career Development Award (K23)
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Diabetes, Endocrinology and Metabolic Diseases B Subcommittee (DDK)
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Rankin, Tracy L
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University of California San Francisco
Internal Medicine/Medicine
Schools of Medicine
San Francisco
United States
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Bansal, Nisha; Roy, Jason; Chen, Hsiang-Yu et al. (2018) Evolution of Echocardiographic Measures of Cardiac Disease From CKD to ESRD and Risk of All-Cause Mortality: Findings From the CRIC Study. Am J Kidney Dis 72:390-399
Bansal, Nisha; Zelnick, Leila R; Alonso, Alvaro et al. (2017) eGFR and Albuminuria in Relation to Risk of Incident Atrial Fibrillation: A Meta-Analysis of the Jackson Heart Study, the Multi-Ethnic Study of Atherosclerosis, and the Cardiovascular Health Study. Clin J Am Soc Nephrol 12:1386-1398
Bansal, Nisha (2017) Evolution of Cardiovascular Disease During the Transition to End-Stage Renal Disease. Semin Nephrol 37:120-131
Bansal, Nisha; Szpiro, Adam; Masoudi, Frederick et al. (2017) Kidney function and appropriateness of device therapies in adults with implantable cardioverter defibrillators. Heart 103:529-537
Airy, Medha; Chang, Tara I; Ding, Victoria Y et al. (2017) Risk profiles for acute health events after incident atrial fibrillation in patients with end-stage renal disease on hemodialysis. Nephrol Dial Transplant :
Zelnick, Leila R; Katz, Ronit; Young, Bessie A et al. (2017) Echocardiographic Measures and Estimated GFR Decline Among African Americans: The Jackson Heart Study. Am J Kidney Dis 70:199-206
Bansal, Nisha; McCulloch, Charles E; Lin, Feng et al. (2017) Blood Pressure and Risk of Cardiovascular Events in Patients on Chronic Hemodialysis: The CRIC Study (Chronic Renal Insufficiency Cohort). Hypertension 70:435-443
Bansal, Nisha; Katz, Ronit; Himmelfarb, Jonathan et al. (2016) Markers of kidney disease and risk of subclinical and clinical heart failure in African Americans: the Jackson Heart Study. Nephrol Dial Transplant 31:2057-2064
Bansal, Nisha (2016) Use of Oral Anticoagulation for Patients with ESRD on Hemodialysis with Atrial Fibrillation: Verdict 1. Clin J Am Soc Nephrol 11:2093-2094
Siew, Edward D; Parr, Sharidan K; Abdel-Kader, Khaled et al. (2016) Predictors of Recurrent AKI. J Am Soc Nephrol 27:1190-200

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