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Biomarkers for Thrombotic Risk Stratification in Nephrotic Syndrome

Award Number: F32DK149663
ORGANIZATION: NATIONAL INSTITUTE OF DIABETES & DIGESTIVE & KIDNEY DISEASES
OPDIV: NIH
AWARD CLASS: DISCRETIONARY
AWARD ACTIVITY TYPE: FELLOWSHIP/SCHOLARSHIP/STUDENT LOANS
PERIOD OF PERFORMANCE START DATE: 01/08/2027
PERIOD OF PERFORMANCE END DATE: 01/07/2028

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Biomarkers for Thrombotic Risk Stratification in Nephrotic Syndrome - Abstract: Nephrotic Syndrome (NS) is a severe and chronic form of glomerular kidney disease that is defined by massive proteinuria, hypoalbuminemia, and edema and is associated with significant morbidity and high healthcare utilization. Thromboembolism (TE) is a life-threatening complication of NS, occurring in 3-8% of children and up to 25% of adults. TE is strongly associated with higher acuity hospital admissions, prolonged length of stay, and increased mortality. The elevated TE risk in NS is multifactorial, driven by urinary loss of key anticoagulants, increased procoagulant synthesis, hypercholesterolemia, and thrombocytosis. Despite this known risk, evidence-based guidelines for prophylactic anticoagulation are severely limited by a critical lack of clear, validated risk stratification thresholds. Furthermore, key mechanistic factors contributing to TE risk remain unexplored, limiting the ability to refine risk prediction and understand underlying pathophysiology. Given that prophylactic anticoagulation is effective at reducing TE risk with a low bleeding risk in other populations, there is an urgent need to identify precise risk factors to guide appropriate patient selection for prophylactic anticoagulation in NS. This fellowship proposal aims to address this knowledge gap by: (1) Establishing clinical risk thresholds for TE by examining the longitudinal association of NS disease activity markers (serum albumin, urine protein: creatinine ratio, cholesterol, and estimated glomerular filtration rate) with time to TE, and (2) Determining the association of TE with a comprehensive panel of novel biomarkers, including hypercoagulability and clot lysis assays, antithrombin levels, and endothelial inflammatory markers, and evaluating their combined value with NS disease activity markers to refine TE risk stratification. These analyses will leverage the extensive repository of longitudinal clinical data and biosamples from the unparalleled and largest glomerular disease cohorts, CureGN and NEPTUNE (N=3,928). The results will directly inform the development of risk-stratification thresholds for prophylaxis in future clinical guidelines and trials. Through conduct of this study, the Candidate will receive specialized training in advanced biostatistics and translational expertise in coagulation biology essential for a future career as an independent physician-scientist focused on coagulation risk in glomerular disease.


Issue Date FY	Funding FY	Legal Entity Name	Legal Entity Address	Legal Entity City	Legal Entity State	Legal Entity Zip Code	Legal Entity COUNTY	Legal Entity COUNTRY	Assistance Listing	Award Code	Budget Year	Action Date	Action Type	Action Amount

Issue Date FY: 2026 ( Subtotal = $86,824 )
2026	2026	THE CHILDREN'S HOSPITAL OF PHILADELPHIA	3401 CIVIC CENTER BLVD	PHILADELPHIA	PA	19104	PHILADELPHIA	USA	Diabetes, Digestive, and Kidney Diseases Extramural Research	000	1	7/16/2026	NEW	$86,824
														Subtotal = $86,824

Grand Total All Awards = $86,824

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Biomarkers for Thrombotic Risk Stratification in Nephrotic Syndrome

Award Number: F32DK149663

ORGANIZATION: NATIONAL INSTITUTE OF DIABETES & DIGESTIVE & KIDNEY DISEASES

OPDIV: NIH

AWARD CLASS: DISCRETIONARY

AWARD ACTIVITY TYPE: FELLOWSHIP/SCHOLARSHIP/STUDENT LOANS

PERIOD OF PERFORMANCE START DATE: 01/08/2027

PERIOD OF PERFORMANCE END DATE: 01/07/2028

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