? Harold I Feldman, M.D., M.S.C.E. is a Professor of Medicine and Epidemiology applying to renew a Mid-career Award in Patient Oriented Research (K24). Dr. Feldman has completed his first term of his K24 with an outstanding record of both mentorship and accomplishment in his patient-oriented research program focusing on kidney disease broadly and renal transplantation more specifically. For this renewal application, Dr. Feldman will continue his mentoring activities for both post-doctoral trainees and junior clinician researchers. He anticipates being the primary faculty mentor for 2 to 3 mentees per year in addition to providing mentorship for faculty in his research Division of Epidemiology. His patient oriented research activities will continue to address problems in chronic kidney disease, but will now focus on the period of disease before individuals become dependent on dialysis or transplantation. Dr. Feldman, will extend his work with and leadership of the NIDDK's Chronic Renal Insufficiency Cohort (CRIC) Study, a 3000-person national cohort study of the intersection of chronic kidney disease (CKD) and cardiovascular illness (CVD). CRIC is nearing completion of recruitment and provides an ideal platform on which to conduct the study of insulin resistance Dr. Feldman proposes. Building on CRIC, the proposed study will be one of the first investigations into insulin resistance and the metabolic syndrome in chronic kidney disease which afflicts over 20 million Americans. The enormous burden of cardiovascular disease among individuals with renal insufficiency makes urgent investigations that will explore mechanisms of accelerated vascular disease in this setting and identify. Insulin resistance is a potent risk factor for cardiovascular disease among individuals without chronic kidney disease and commonly co-exists with renal insufficiency. The principal goals of the proposed study are to determine the relationships of insulin resistance to the level of renal function, to other features of the metabolic syndrome, to CVD events, and to progression of kidney disease. Exploration of insulin metabolism in CKD will be a secondary aim. This study will use a validated measure of insulin resistance calculated from fasting insulin and glucose levels for all CRIC subjects. Both cross- sectional and longitudinal analyses will expand our understanding of the excess risk of CVD and identify potential targets for novel therapies to reduce CVD burden in the setting of CKD. ? ?

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 #
5K24DK002651-08
Application #
7489361
Study Section
Diabetes, Endocrinology and Metabolic Diseases B Subcommittee (DDK)
Program Officer
Rankin, Tracy L
Project Start
1999-09-25
Project End
2011-08-31
Budget Start
2008-09-01
Budget End
2009-08-31
Support Year
8
Fiscal Year
2008
Total Cost
$182,718
Indirect Cost
Name
University of Pennsylvania
Department
Internal Medicine/Medicine
Type
Schools of Medicine
DUNS #
042250712
City
Philadelphia
State
PA
Country
United States
Zip Code
19104
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Shah, Rachana; Matthews, Gregory J; Shah, Rhia Y et al. (2015) Serum Fractalkine (CX3CL1) and Cardiovascular Outcomes and Diabetes: Findings From the Chronic Renal Insufficiency Cohort (CRIC) Study. Am J Kidney Dis 66:266-73
Deo, Rajat; Yang, Wei; Khan, Abigail M et al. (2014) Serum aldosterone and death, end-stage renal disease, and cardiovascular events in blacks and whites: findings from the Chronic Renal Insufficiency Cohort (CRIC) Study. Hypertension 64:103-10
Ricardo, Ana C; Yang, Wei; Lora, Claudia M et al. (2014) Limited health literacy is associated with low glomerular filtration in the Chronic Renal Insufficiency Cohort (CRIC) study. Clin Nephrol 81:30-7
Reese, P P; Bloom, R D; Feldman, H I et al. (2014) Mortality and cardiovascular disease among older live kidney donors. Am J Transplant 14:1853-61
Reese, Peter P; Bloom, Roy D; Shults, Justine et al. (2014) Functional status and survival after kidney transplantation. Transplantation 97:189-95
Rahman, Mahboob; Xie, Dawei; Feldman, Harold I et al. (2014) Association between chronic kidney disease progression and cardiovascular disease: results from the CRIC Study. Am J Nephrol 40:399-407
Liu, Kathleen D; Yang, Wei; Anderson, Amanda H et al. (2013) Urine neutrophil gelatinase-associated lipocalin levels do not improve risk prediction of progressive chronic kidney disease. Kidney Int 83:909-14

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