? Chronic kidney disease (CKD) is a public health problem with ~20 million affected in the US. CKD is known to have adverse effects on the cardiovascular system, the aging process as well as cognitive function.
The aim of this K24 program is provide support for Dr. Sarnak's patient oriented research (POR) program and mentorship for his trainees in these topics. Dr. Sarnak is currently supported as the Principal Investigator though three Federal grants including those from the 1. The Cardiovascular Risk Factors in Kidney Disease Pooling Project 2. Kidney Disease in the Cardiovascular Health Study, a cohort study of older adults and 3. Cognition and Vascular Disease in Dialysis Patients. These three studies as well as a wide variety of other multicenter collaborations provide opportunities for hypothesis generation and independent research for Dr Sarnak's trainees. Since 2000 Dr. Sarnak has mentored 15 residents or research fellows, and been senior author on 21 peer-reviewed articles with his mentee as the first author. Three of his previous mentees are currently POR's and members of the Division of Nephrology at Tufts New England Medical Center. His mentees would be supported by a T32 National Research Service Award (NRSA DK007777), as well as current and future K23 awards that have been awarded to Division of Nephrology. Dr. Sarnak is the Associate Director of the T32 NRSA. All trainees would complete 1) Didactic Training - course work in fulfillment of the MS degree in the Graduate Program in Clinical Research at the Sackler School of Graduate Biomedical Sciences at Tufts University. 2) Independent Study - an hypothesis-based research project supervised by a Dr. Sarnak and a research team of faculty with expertise in other disciplines and 3) Training in Presentation - participation in conferences and seminars designed to improve trainees' oral and written presentations. K23 awardees mentored by Dr. Sarnak also participate on his research team and in mentoring, creating an outstanding environment for training new clinician-investigators. ? This application also includes a new proposal for long term follow up of the randomized and non randomized cohorts of the Modification of Diet in Renal Disease (MDRD) Study with the broad aims of evaluating risk factors for kidney failure, hypoalbuminemia and cardiovascular disease at the time of kidney failure, and all cause mortality in 15 years of follow-up. ? CKD is a public health problem of epidemic proportions with profound implications in terms of morbidity, mortality and resource utilization. Preventing the development and retarding the progression of CKD, as well as its associated complications such as cardiovascular disease, unsuccessful aging and development of cognitive abnormalities, will potentially impact the health of the nation and reduce health care costs. Training future investigators in POR will be essential to reduce the burden of CKD in the future. ? ?

National Institute of Health (NIH)
National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK)
Midcareer Investigator Award in Patient-Oriented Research (K24)
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Diabetes, Endocrinology and Metabolic Diseases B Subcommittee (DDK)
Program Officer
Rankin, Tracy L
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Tufts University
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Drew, David A; Weiner, Daniel E; Tighiouart, Hocine et al. (2017) Cognitive Decline and Its Risk Factors in Prevalent Hemodialysis Patients. Am J Kidney Dis 69:780-787
Brown, Jeremiah R; Rezaee, Michael E; Hisey, William M et al. (2016) Reduced Mortality Associated with Acute Kidney Injury Requiring Dialysis in the United States. Am J Nephrol 43:261-70
Garimella, Pranav S; Ix, Joachim H; Katz, Ronit et al. (2015) Association of albumin-creatinine ratio and cystatin C with change in ankle-brachial index: the Multi-Ethnic Study of Atherosclerosis (MESA). Am J Kidney Dis 65:33-40
Ku, Elaine; Glidden, David V; Johansen, Kirsten L et al. (2015) Association between strict blood pressure control during chronic kidney disease and lower mortality after onset of end-stage renal disease. Kidney Int 87:1055-60
Drew, David A; Weiner, Daniel E; Tighiouart, Hocine et al. (2015) Cognitive function and all-cause mortality in maintenance hemodialysis patients. Am J Kidney Dis 65:303-11
Garimella, Pranav S; Ix, Joachim H; Katz, Ronit et al. (2014) Fibroblast growth factor 23, the ankle-brachial index, and incident peripheral artery disease in the Cardiovascular Health Study. Atherosclerosis 233:91-6
Fan, Li; Tighiouart, Hocine; Levey, Andrew S et al. (2014) Urinary sodium excretion and kidney failure in nondiabetic chronic kidney disease. Kidney Int 86:582-8
Brown, Jeremiah R; Solomon, Richard J; Sarnak, Mark J et al. (2014) Reducing contrast-induced acute kidney injury using a regional multicenter quality improvement intervention. Circ Cardiovasc Qual Outcomes 7:693-700
Drew, David A; Tighiouart, Hocine; Scott, Tammy et al. (2014) Asymmetric dimethylarginine, race, and mortality in hemodialysis patients. Clin J Am Soc Nephrol 9:1426-33
Fan, Li; Sarnak, Mark J; Tighiouart, Hocine et al. (2014) Depression and all-cause mortality in hemodialysis patients. Am J Nephrol 40:12-8

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