Improving Cardiovascular Risk Stratification in Kidney Transplant Recipients
Principal Investigator: Meyeon Park
Funding Source: Doris Duke Charitable Foundation Clinical Scientist Development Award
Project Summary: Dr. Meyeon Park, MD is forming the UCSF Pediatric and Adult Kidney Transplant (PAKT) cohort study, which is funded by the UCSF Department of Medicine Centers of Excellence in Patient Research Pilot Award. Her aim is to create a clinical research database and specimen biorepository of kidney transplant recipients at UCSF. This is the foundation for an observational study of risk factors of cardiovascular disease in kidney transplant recipients and the overall goal is to foster translational collaborations across departments and divisions at UCSF.
Novel Echocardiographic Methods to Characterize Heart Failure in ESRD
Principal Investigator: Ruth Dubin
Funding Source: National Institute of Diabetes and Digestive and Kidney Diseases (R03DK104013_01A1)
Project Summary: Although patients with end-stage renal disease (ESRD) suffer high morbidity and mortality due to heart failure, we lack diagnostic guidelines for the use of echocardiography in these patients. We will compare the performance of traditional and novel methods for predicting heart failure hospitalizations and mortality in this high-risk population. W anticipate that our data will lead to larger studies aimed at defining and optimizing echocardiographic assessment of cardiac function in ESRD.
Elucidating Pathways of Vascular Dysfunction and Myocardial Injury in ESRD
Principal Investigator: Ruth Dubin
Funding Source: National Institute of Diabetes and Digestive and Kidney Diseases (5K23DK092354)
Project Summary: Dr. Dubin has studied the effects of dialysis on cardiac function and post-dialysis fatigue, as well as predictors of troponin T in chronic kidney disease. Currently, Dr. Dubin is recruiting a unique cohort of 200 patients with ESRD who undergo detailed echocardiographic and vascular exams the day following the first dialysis session of the week. Patients are followed for cardiovascular hospitalizations and deaths. The goals of this project are 1) to elucidate mechanisms of vascular dysfunction (endothelial dysfunction and arterial stiffness) and myocardial injury (measured as troponin T) in the setting of ESRD, and 2) to evaluate novel echocardiographic parameters as predictors of cardiovascular disease and overall mortality in the setting of ESRD.
Prevalence and Impact of Frailty on Dialysis Patients
Principal Investigator: Kirsten Johansen
Funding Source: National Institute of Diabetes and Digestive and Kidney Diseases (5K24DK085153)
Project Summary: Because of the increasing number of new cases of ESRD in the US and the associated patient morbidity and costs, chronic kidney disease was designated as a focus area of Healthy People 2010, with the explicit goal to "reduce new cases of chronic kidney disease and its complications, disability, death, and economic costs." This project aims to investigate frailty, a major complication of ESRD, to determine the extent to which it increases the risk of death and hospitalization (a major contributor to the cost of ESRD). This project will also investigate oxidative stress as a potential contributor to frailty and the potential of a pedometer-based intervention to increase physical activity and improve physical performance and endothelial function. Results of this work may lead to further investigation of strategies to reduce frailty and thus increase quality of life and possibly reduce mortality or hospitalization in this population.