Dr. Kurella is a nephrologist and Assistant Adjunct Professor in the Department of Medicine at the University of California San Francisco. The candidate's long-term career goal is to develop an independent research career in geriatric nephrology, specifically focused on elucidating the mechanisms of cognitive impairment among elderly with end-stage renal disease (ESRD). The elderly are the fastest growing segment of the end-stage renal disease population, and the candidate's previous studies have demonstrated that the burden of cognitive impairment in this population is strikingly high and unexplained by conventional risk factors. The proposed career development plan integrates focused training in geriatrics, dementia, and neuroimaging, mentored research experience, and biostatistics training tailored to the candidate's multi-disciplinary research career plans. With the guidance of a multi-disciplinary team of mentors with expertise in dementia, geriatrics, nephrology and biostatistics, the candidate will use cognitive impairment as a model for understanding how kidney disease contributes to accelerated aging and geriatric syndromes such as dementia and disability. This proposal will (1) evaluate several metabolic and structural mechanisms of cognitive decline in ESRD by prospectively assembling a cohort of dialysis patients, and (2) test the effects of a novel dialysis therapy on cognitive function within the framework of a randomized clinical trial. The results of these studies will build incrementally on the candidate's prior research and will provide critical insight into the epidemiology and mechanisms of cognitive impairment that will guide the long-range goals of this project, a clinical trial evaluating strategies to prevent cognitive decline in elderly persons with chronic kidney disease and ESRD, to be submitted as an R01 grant application in Year 3 or 4 of the award. ? ? ?

Agency
National Institute of Health (NIH)
Institute
National Institute on Aging (NIA)
Type
Mentored Patient-Oriented Research Career Development Award (K23)
Project #
5K23AG028952-02
Application #
7490589
Study Section
Special Emphasis Panel (ZAG1-ZIJ-4 (M1))
Program Officer
Wagster, Molly V
Project Start
2007-09-01
Project End
2008-09-02
Budget Start
2008-09-01
Budget End
2008-09-02
Support Year
2
Fiscal Year
2008
Total Cost
$176,965
Indirect Cost
Name
University of California San Francisco
Department
Internal Medicine/Medicine
Type
Schools of Medicine
DUNS #
094878337
City
San Francisco
State
CA
Country
United States
Zip Code
94143
Kurella Tamura, Manjula; Chertow, Glenn M; Depner, Thomas A et al. (2016) Metabolic Profiling of Impaired Cognitive Function in Patients Receiving Dialysis. J Am Soc Nephrol 27:3780-3787
Kavanagh, Niall T; Schiller, Brigitte; Saxena, Anjali B et al. (2015) Prevalence and correlates of functional dependence among maintenance dialysis patients. Hemodial Int 19:593-600
Kurella Tamura, Manjula; Unruh, Mark L; Nissenson, Allen R et al. (2013) Effect of more frequent hemodialysis on cognitive function in the frequent hemodialysis network trials. Am J Kidney Dis 61:228-37
Kurella Tamura, Manjula; Meyer, Jaclyn Biada; Saxena, Anjali B et al. (2012) Prevalence and significance of stroke symptoms among patients receiving maintenance dialysis. Neurology 79:981-7
Kurella Tamura, Manjula; Winkelmayer, Wolfgang C (2012) Treated and untreated kidney failure in older adults: what's the right balance? JAMA 307:2545-6
Abra, Graham; Kurella Tamura, Manjula (2012) Timing of initiation of dialysis: time for a new direction? Curr Opin Nephrol Hypertens 21:329-33
Tamura, Manjula Kurella; Tan, Jane C; O'Hare, Ann M (2012) Optimizing renal replacement therapy in older adults: a framework for making individualized decisions. Kidney Int 82:261-9
Anand, Shuchi; Kaysen, George A; Chertow, Glenn M et al. (2011) Vitamin D deficiency, self-reported physical activity and health-related quality of life: the Comprehensive Dialysis Study. Nephrol Dial Transplant 26:3683-8
Cheung, Katharine Lana; Soman, Sandeep; Tamura, Manjula Kurella (2011) Special considerations in the management of chronic kidney disease in the elderly. Dial Transplant 40:241-243
Kurella Tamura, Manjula; Anand, Shuchi; Li, Suying et al. (2011) Comparison of CKD awareness in a screening population using the Modification of Diet in Renal Disease (MDRD) study and CKD Epidemiology Collaboration (CKD-EPI) equations. Am J Kidney Dis 57:S17-23

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