Management of anemia due to end-stage renal disease is a multifactorial decision process involving administration of recombinant human erythropoietin (rHuEPO) and iron, as well as assessment of other factors influencing the progress of the disease. This application aims at improving the cost-effectiveness of this process through the use of state-of-the-art numerical tools from control engineering and machine learning.
The specific aims are the collection of anemia management data and development of new guidelines for period of measuring hemoglobin levels if necessary, development of individualized, computer-assisted approach to rHuEPO dosing based on modern control engineering and machine learning approach, evaluation of the developed tools through numeric simulation and assessment of the potential improvements in therapy and projected savings in rHuEPO utilization.
The final aim i s to provide a physical implementation and to perform a clinical evaluation of the developed methodology. The applicant, Dr. Adam E. Gaweda, is an Instructor of Medicine in the Department of Medicine, Division of Nephrology at the University of Louisville. His original training is in the field of electrical engineering (M.Eng.) and computer science (Ph.D.). The applicant plans to develop as an independent and well established researcher in the field of biomedical engineering with focus on translation of state-of-the-art technology to heath care. To achieve this goal the applicant will enroll into the Clinical Research, Epidemiology and Statistics Training (CREST) Program at the University of Louisville, School of Public Health and Information Sciences

National Institute of Health (NIH)
National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK)
Mentored Quantitative Research Career Development Award (K25)
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Diabetes, Endocrinology and Metabolic Diseases B Subcommittee (DDK)
Program Officer
Rankin, Tracy L
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University of Louisville
Internal Medicine/Medicine
Schools of Medicine
United States
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Gaweda, Adam E; Aronoff, George R; Jacobs, Alfred A et al. (2014) Individualized anemia management reduces hemoglobin variability in hemodialysis patients. J Am Soc Nephrol 25:159-66
Krzyzanski, Wojciech; Brier, Michael E; Creed, Timothy M et al. (2013) Reticulocyte-based estimation of red blood cell lifespan. Exp Hematol 41:817-22
Merchant, Michael L; Gaweda, Adam E; Dailey, Andrew J et al. (2011) Oncostatin M receptor ? and cysteine/histidine-rich 1 are biomarkers of the response to erythropoietin in hemodialysis patients. Kidney Int 79:546-554
Brier, Michael E; Gaweda, Adam E (2011) Predictive modeling for improved anemia management in dialysis patients. Curr Opin Nephrol Hypertens 20:573-6
Nichols, B; Shrestha, R P; Horowitz, J et al. (2011) Simplification of an erythropoiesis model for design of anemia management protocols in end stage renal disease. Conf Proc IEEE Eng Med Biol Soc 2011:83-6
Brier, Michael E; Gaweda, Adam E; Dailey, Andrew et al. (2010) Randomized trial of model predictive control for improved anemia management. Clin J Am Soc Nephrol 5:814-20
Gaweda, Adam E; Goldsmith, Linda J; Brier, Michael E et al. (2010) Iron, inflammation, dialysis adequacy, nutritional status, and hyperparathyroidism modify erythropoietic response. Clin J Am Soc Nephrol 5:576-81
Gaweda, Adam E; Nathanson, Brian H; Jacobs, Alfred A et al. (2010) Determining optimum hemoglobin sampling for anemia management from every-treatment data. Clin J Am Soc Nephrol 5:1939-45
Gaweda, Adam E; Jacobs, Alfred A; Aronoff, George R et al. (2008) Model predictive control of erythropoietin administration in the anemia of ESRD. Am J Kidney Dis 51:71-9
Gaweda, A E; Jacobs, A A; Brier, M E (2008) Application of fuzzy logic to predicting erythropoietic response in hemodialysis patients. Int J Artif Organs 31:1035-42