This is an application for a K23 award for Dr. Vanessa Grubbs, a nephrologist at the University of California, San Francisco, who seeks to establish herself as a young investigator in patient-oriented clinical research on the periodontal-chronic kidney disease relation. This K23 award will provide Dr. Grubbs with the support necessary to accomplish the following goals: (1) to become expert at patient-oriented clinical research in the study of the periodontal-chronic kidney disease relation;(2) to conduct clinical investigations of the effect of periodontal disease on chronic kidney disease (CKD) progression;(3) to implement advanced biostatistical methods in clinical studies;(4) to develop and implement a pilot intervention study;and (5) to develop an independent clinical research career. To achieve these goals, Dr. Grubbs has assembled a mentoring team comprised of two co-primary mentors: Dr. Kirsten Bibbins-Domingo, an internist and epidemiologist funded by the NIH, with expertise in population research in CKD and cardiovascular disease among vulnerable populations and Dr. Neil Powe, the Constance B. Wofsy Distinguished Professor of Medicine and NIH-funded researcher in kidney disease. Her multidisciplinary mentoring team also includes Drs. David Lovett, a nephrologist whose research focuses on proinflammatory pathways of renal fibrosis and progression,;Steven Offenbacher, a periodontologist whose research focuses on the systemic effect of periodontal pathogens;and Peter Ganz, a cardiologist and renowned expert in endothelial function. Chronic kidney disease remains a prevalent public health issue despite intense efforts targeting traditional risk factors. Dr. Grubb'research will focus on defining the independent effect of a novel risk factor, periodontal disease, on kidney function decline and factors that may predispose greater risk in both the general population (Aim 1) and among a population at high risk for CKD progression (Aim 2) and to pilot an intervention of intensive periodontal disease treatment among an underserved population with CKD (Aim 3).
For Aims 1 and 2 Dr. Grubbs will capitalize on existing cohort data from the National Health and Nutrition Examination Survey and the Jackson Heart Study linked to create longitudinal data and utilize advanced multivariate statistical analyses. The pilot study in Aim 3 will provide the basis for a large, multi-site intervention trial to determine to what extent treatment of periodontal disease can slow progression of clinically evident kidney disease, to be proposed in an R01 grant application towards the end of the K award.

Public Health Relevance

Chronic kidney disease (CKD) represents a substantial public health burden through both increased morbidity and mortality and financial costs that disproportionately affect communities of color. Improved understanding of modifiable factors, such as periodontal disease, that may slow or prevent CKD progression is critical to decreasing the burden of CKD.

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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Study Section
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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Grubbs, Vanessa; O'Riordan, David; Pantilat, Steve (2017) Characteristics and Outcomes of In-Hospital Palliative Care Consultation among Patients with Renal Disease Versus Other Serious Illnesses. Clin J Am Soc Nephrol 12:1085-1089
Grubbs, Vanessa; Tuot, Delphine S; Powe, Neil R et al. (2017) System-Level Barriers and Facilitators for Foregoing or Withdrawing Dialysis: A Qualitative Study of Nephrologists inĀ theĀ United States and England. Am J Kidney Dis 70:602-610
Grubbs, Vanessa; Garcia, Faviola; Jue, Bonnie L et al. (2017) The Kidney and Periodontal Disease (KAPD) study: A pilot randomized controlled trial testing the effect of non-surgical periodontal therapy on chronic kidney disease. Contemp Clin Trials 53:143-150
Grubbs, Vanessa; Vittighoff, Eric; Grimes, Barbara et al. (2016) Mortality and illicit drug dependence among hemodialysis patients in the United States: a retrospective cohort analysis. BMC Nephrol 17:56
Grubbs, Vanessa; Vittinghoff, Eric; Taylor, George et al. (2016) The association of periodontal disease with kidney function decline: a longitudinal retrospective analysis of the MrOS dental study. Nephrol Dial Transplant 31:466-72
Grubbs, Vanessa; Vittinghoff, Eric; Beck, James D et al. (2015) Association Between Periodontal Disease and Kidney Function Decline in African Americans: The Jackson Heart Study. J Periodontol 86:1126-32
Greer, Raquel C; Ameling, Jessica M; Cavanaugh, Kerri L et al. (2015) Specialist and primary care physicians' views on barriers to adequate preparation of patients for renal replacement therapy: a qualitative study. BMC Nephrol 16:37
Tuot, Delphine S; Grubbs, Vanessa (2015) Chronic kidney disease care in the US safety net. Adv Chronic Kidney Dis 22:66-73
Kshirsagar, Abhijit V; Grubbs, Vanessa (2015) Periodontal Disease and CKD-Associated Morbidity: Is There Now Enough Evidence to Move From Observation to Intervention? Am J Kidney Dis 66:181-3
Grubbs, Vanessa (2014) Undocumented immigrants and kidney transplant: costs and controversy. Health Aff (Millwood) 33:332-5

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