BURDEN OF CHRONIC KIDNEY DISEASE IN HIV INFECTION
Michelle M Estrella
Johns Hopkins University, 3400 N Charles St, Baltimore, Md 21218
Grant 1K23DK081317-01A1 from National Institute Of Diabetes And Digestive And Kidney Diseases
Abstract: The overall goal of this application is to support the education and clinical research of the investigator leading to an independent career in patient-oriented research focused on HIV-related kidney disease. With the career development award and a program of didactic and scientific training, the goals will be achieved by 1) receiving direct mentorship in study methods, statistical analysis, scientific communication and manuscript preparation 2) obtaining formal instruction in the Graduate Training Program in Clinical Investigation and advanced courses in cohort design/ statistical analysis and genetic epidemiology and 3) implementing the research proposal with guidance and input from mentors and collaborators in the supportive environment offered by the Johns Hopkins Schools of Medicine and Public Health, and the Welch Center for Prevention, Epidemiology and Clinical Research. Survival of HIV-infected individuals has improved significantly with highly active antiretroviral therapy (HAART); consequently, chronic illnesses such as kidney disease are of increasing concern. The overall aim of the proposal is to quantify the burden of chronic kidney disease (CKD) in HIV-infected individuals using serum creatinine and cystatin C and to investigate whether HIV- and host-related factors are involved in the development and progression of CKD in HIV-positive individuals. This proposal will use two unique study populations 1) a large, racially diverse population of HIV-positive individuals with extended follow-up from the Multicenter AIDS Cohort Study (MACS) and the Womens´ Interagency HIV Study (WIHS) cohorts; and 2) a clinic-based study population of HIV-positive individuals recruited through the Johns Hopkins HIV/AIDS Service. This proposal will provide 1) the current epidemiology of HIV-related CKD in the U.S. and its impact on mortality; 2) a comparison of the prevalence of CKD based on cystatin C versus serum creatinine estimates of kidney function; 3) an investigation of the risk of CKD development and progression related to HAART and HIV disease stage; and 4) a validation of the association of MYH9 with CKD progression and specific renal histopathologic findings. This proposal will have important implications in screening and identifying CKD in this high risk population. It will determine the impact of CKD in the natural history of HIV infection and determine risk factors for CKD during the HAART era. It will yield a potential mechanism for HIV-related CKD which may ultimately lead to the development of diagnostic and prognostic markers for HIV-related CKD
Keywords: 4H-Imidazol-4-one, 2-amino-1, 5-dihydro-1-methyl-; AIDS; AIDS Seroconversion; AIDS Seropositivity; AIDS Virus; AIDS/HIV; AIDS/HIV problem; Acquired Immune Deficiency; Acquired Immune Deficiency Syndrome; Acquired Immune Deficiency Syndrome Virus; Acquired Immuno-Deficiency Syndrome; Acquired Immunodeficiency Syndrome; Acquired Immunodeficiency Syndrome Virus; Active Follow-up; African American; Afro American; Afroamerican; Alleles; Allelomorphs; American; Anti-HIV Positivity; Anti-Retroviral Agents; Antiretroviral Agents; Antiretroviral Therapy, Highly Active; Biopsy; Black Populations; Black or African American; Blood Serum; CD4 Lymphocyte Count; CD4+ Cell Counts; CD4+ Counts; CREA; Career Development Awards; Career Development Awards and Programs; Career Development Programs K-Series; Cessation of life; Chronic; Chronic Disease; Chronic Illness; Chronic Kidney Failure; Chronic Renal Disease; Clinic; Clinical Research; Clinical Study; Clinical Trials; Clinical Trials, Unspecified; Cohort Studies; Communication; Concurrent Studies; Creatinine; Death; Development; Diabetes Mellitus; Diagnostic; Disease; Disease Progression; Disorder; Drugs; ESRD; Education; Educational aspects; End stage renal failure; End-Stage Kidney Disease; Environment; Epidemiology; Evaluation; Excretory function; Family; Gene Products, RNA; General Population; General Public; Genetic; Genetic Risk; Glomerular Filtration Rate; Goals; Guidelines; HAART; HIV; HIV Antibody Positivity; HIV Infections; HIV Positive; HIV Positivity; HIV Seroconversion; HIV Seropositivity; HIV-1; HIV-I; HIV/AIDS; HIV/AIDS problem; HIV1; HTLV-III; HTLV-III Infections; HTLV-III Seroconversion; HTLV-III Seropositivity; HTLV-III-LAV Infections; Heterogeneity, Population; Highly Active Antiretroviral Therapy; Histopathology; Human Immunodeficiency Viruses; Human T-Cell Leukemia Virus Type III; Human T-Cell Lymphotropic Virus Type III; Human T-Lymphotropic Virus Type III; Human immunodeficiency virus 1; Immunodeficiency Virus Type 1, Human; Immunologic Deficiency Syndrome, Acquired; Incidence; Individual; Infrastructure; Institution; Instruction; Investigation; Investigators; Isoforms; K-Awards; K-Series Research Career Programs; Kidney; Kidney Diseases; Kidney Failure, Chronic; LAV-HTLV-III; Lead; Life; Longitudinal Studies; Lymphadenopathy-Associated Virus; Manuscripts; Measurement; Medical; Medication; Mentors; Mentorship; Minority; Molecular Marker of Prognosis; Morbidity; Morbidity - disease rate; Mortality; Mortality Vital Statistics; Myosin Heavy Chains; Natural History; Nephropathy; Observational Study; Participant; Patients; Pb element; Persons; Pharmaceutic Preparations; Pharmaceutical Preparations; Population; Population Heterogeneity; Population Study; Predisposition; Preparation; Prevalence; Prevention; Prognosis Marker; Prognostic Marker; Programs (PT); Programs [Publication Type]; Prospective Studies; Protein Isoforms; Proteinuria; Public Health; RNA; RNA, Non-Polyadenylated; Recruitment Activity; Renal Disease; Renal Disease, End-Stage; Renal Failure, Chronic; Renal function; Research Career Program; Research Career Programs, K-Series; Research Infrastructure; Research Personnel; Research Proposals; Researchers; Ribonucleic Acid; Risk; Risk Factors; Schools, Medical; Screening procedure; Serum; Services; Staging; Staining method; Stainings; Stains; Statistical Methods; Susceptibility; T-Lymphotropic Virus Type III Infections, Human; T4 Lymphocyte Count; Time; Training; Training Programs; Urinary System, Kidney; Validation; Variant; Variation; Virus-HIV; Woman; anti-retroviral; anti-retroviral therapy, highly active; antibody positive AIDS test; antigen positive AIDS test; antiretroviral; antiretroviral therapy; base; black American; career; chronic disease/disorder; chronic disorder; chronic kidney disease; clinical investigation; cohort; cystatin C; design; designing; diabetes; disease/disorder; diverse populations; drug/agent; excretion; experience; follow-up; genetic epidemiology; heavy metal Pb; heavy metal lead; heterogeneous population; high risk; human T cell leukemia virus III; human T lymphotropic virus III; improved; kidney disorder; kidney function; long-term study; mRNA Expression; medical schools; muscle form; myosin heavy chain; nephrotoxicity; novel; patient oriented research; patient oriented study; patient population; post gamma-globulins; post-gamma-protein; programs; public health medicine (field); public health relevance; race differences; racial difference; recruit; renal; renal disorder; screening; screenings; seropositive (AIDS test); skills; urinary
Project start date: 2009-07-01
Project end date: 2014-06-30
Budget start date: 1-JUL-2009
Budget end date: 30-JUN-2010
PFA/PA: PA-05-143
1K23DK081317-01A1 (2009): $172332
Sponsored Links Excellgen http://Excellgen.com
Grants awarded to Michelle M Estrella
BURDEN OF CHRONIC KIDNEY DISEASE IN HIV INFECTION
Michelle M Estrella
Johns Hopkins University, W400 Wyman Park Building, Baltimore, Md 21218
Grant 5K23DK081317-02 from National Institute Of Diabetes And Digestive And Kidney Diseases
Abstract: The overall goal of this application is to support the education and clinical research of the investigator leading to an independent career in patient-oriented research focused on HIV-related kidney disease. With the career development award and a program of didactic and scientific training, the goals will be achieved by 1) receiving direct mentorship in study methods, statistical analysis, scientific communication and manuscript preparation 2) obtaining formal instruction in the Graduate Training Program in Clinical Investigation and advanced courses in cohort design/ statistical analysis and genetic epidemiology and 3) implementing the research proposal with guidance and input from mentors and collaborators in the supportive environment offered by the Johns Hopkins Schools of Medicine and Public Health, and the Welch Center for Prevention, Epidemiology and Clinical Research. Survival of HIV-infected individuals has improved significantly with highly active antiretroviral therapy (HAART); consequently, chronic illnesses such as kidney disease are of increasing concern. The overall aim of the proposal is to quantify the burden of chronic kidney disease (CKD) in HIV-infected individuals using serum creatinine and cystatin C and to investigate whether HIV- and host-related factors are involved in the development and progression of CKD in HIV-positive individuals. This proposal will use two unique study populations 1) a large, racially diverse population of HIV-positive individuals with extended follow-up from the Multicenter AIDS Cohort Study (MACS) and the Womens´ Interagency HIV Study (WIHS) cohorts; and 2) a clinic-based study population of HIV-positive individuals recruited through the Johns Hopkins HIV/AIDS Service. This proposal will provide 1) the current epidemiology of HIV-related CKD in the U.S. and its impact on mortality; 2) a comparison of the prevalence of CKD based on cystatin C versus serum creatinine estimates of kidney function; 3) an investigation of the risk of CKD development and progression related to HAART and HIV disease stage; and 4) a validation of the association of MYH9 with CKD progression and specific renal histopathologic findings. This proposal will have important implications in screening and identifying CKD in this high risk population. It will determine the impact of CKD in the natural history of HIV infection and determine risk factors for CKD during the HAART era. It will yield a potential mechanism for HIV-related CKD which may ultimately lead to the development of diagnostic and prognostic markers for HIV-related CKD
Keywords: 4H-Imidazol-4-one, 2-amino-1, 5-dihydro-1-methyl-; AIDS; AIDS Seroconversion; AIDS Seropositivity; AIDS Virus; AIDS/HIV; AIDS/HIV problem; Acquired Immune Deficiency; Acquired Immune Deficiency Syndrome; Acquired Immune Deficiency Syndrome Virus; Acquired Immuno-Deficiency Syndrome; Acquired Immunodeficiency Syndrome; Acquired Immunodeficiency Syndrome Virus; Active Follow-up; African American; Afro American; Afroamerican; Alleles; Allelomorphs; American; Anti-HIV Positivity; Anti-Retroviral Agents; Antiretroviral Agents; Antiretroviral Therapy, Highly Active; Biopsy; Black Populations; Black or African American; Blood Serum; CD4 Lymphocyte Count; CD4+ Cell Counts; CD4+ Counts; CREA; Career Development Awards; Career Development Awards and Programs; Career Development Programs K-Series; Cessation of life; Chronic; Chronic Disease; Chronic Illness; Chronic Kidney Failure; Chronic Renal Disease; Clinic; Clinical Research; Clinical Study; Clinical Trials; Clinical Trials, Unspecified; Cohort Studies; Communication; Concurrent Studies; Creatinine; Death; Development; Diabetes Mellitus; Diagnostic; Disease; Disease Progression; Disorder; Drugs; ESRD; Education; Educational aspects; End stage renal failure; End-Stage Kidney Disease; Environment; Epidemiology; Evaluation; Excretory function; Family; Gene Products, RNA; General Population; General Public; Genetic; Genetic Risk; Glomerular Filtration Rate; Goals; Guidelines; HAART; HIV; HIV Antibody Positivity; HIV Infections; HIV Positive; HIV Positivity; HIV Seroconversion; HIV Seropositivity; HIV-1; HIV-I; HIV/AIDS; HIV/AIDS problem; HIV1; HTLV-III; HTLV-III Infections; HTLV-III Seroconversion; HTLV-III Seropositivity; HTLV-III-LAV Infections; Heterogeneity, Population; Highly Active Antiretroviral Therapy; Histopathology; Human Immunodeficiency Viruses; Human T-Cell Leukemia Virus Type III; Human T-Cell Lymphotropic Virus Type III; Human T-Lymphotropic Virus Type III; Human immunodeficiency virus 1; Immunodeficiency Virus Type 1, Human; Immunologic Deficiency Syndrome, Acquired; Incidence; Individual; Infrastructure; Institution; Instruction; Investigation; Investigators; Isoforms; K-Awards; K-Series Research Career Programs; Kidney; Kidney Diseases; Kidney Failure, Chronic; LAV-HTLV-III; Lead; Life; Longitudinal Studies; Lymphadenopathy-Associated Virus; Manuscripts; Measurement; Medical; Medication; Mentors; Mentorship; Minority; Molecular Marker of Prognosis; Morbidity; Morbidity - disease rate; Mortality; Mortality Vital Statistics; Myosin Heavy Chains; Natural History; Nephropathy; Observational Study; Participant; Patients; Pb element; Persons; Pharmaceutic Preparations; Pharmaceutical Preparations; Population; Population Heterogeneity; Population Study; Predisposition; Preparation; Prevalence; Prevention; Prognosis Marker; Prognostic Marker; Programs (PT); Programs [Publication Type]; Prospective Studies; Protein Isoforms; Proteinuria; Public Health; RNA; RNA, Non-Polyadenylated; Recruitment Activity; Renal Disease; Renal Disease, End-Stage; Renal Failure, Chronic; Renal function; Research Career Program; Research Career Programs, K-Series; Research Infrastructure; Research Personnel; Research Proposals; Researchers; Ribonucleic Acid; Risk; Risk Factors; Screening procedure; Serum; Services; Staging; Staining method; Stainings; Stains; Statistical Methods; Susceptibility; T-Lymphotropic Virus Type III Infections, Human; T4 Lymphocyte Count; Time; Training; Training Programs; Urinary System, Kidney; Validation; Variant; Variation; Virus-HIV; Woman; anti-retroviral; anti-retroviral therapy, highly active; antibody positive AIDS test; antigen positive AIDS test; antiretroviral; antiretroviral therapy; base; black American; career; chronic disease/disorder; chronic disorder; chronic kidney disease; clinical investigation; cohort; cystatin C; design; designing; diabetes; disease/disorder; diverse populations; drug/agent; excretion; experience; follow-up; genetic epidemiology; heavy metal Pb; heavy metal lead; heterogeneous population; high risk; human T cell leukemia virus III; human T lymphotropic virus III; improved; kidney disorder; kidney function; long-term study; mRNA Expression; medical schools; muscle form; myosin heavy chain; nephrotoxicity; novel; patient oriented research; patient oriented study; patient population; post gamma-globulins; post-gamma-protein; programs; public health medicine (field); race differences; racial difference; recruit; renal; renal disorder; screening; screenings; seropositive (AIDS test); skills; urinary
Project start date: 2009-07-01
Project end date: 2014-06-30
Budget start date: 1-JUL-2010
Budget end date: 30-JUN-2011
PFA/PA: PA-05-143
5K23DK081317-02 (2010): $174740