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SUB-OPTIMAL PRE-ESRD CARE AND ITS IMPACT ON OUTCOMES

Award Number: K08DK002745
ORGANIZATION: NATIONAL INSTITUTE OF DIABETES & DIGESTIVE & KIDNEY DISEASES
OPDIV: NIH
AWARD CLASS: DISCRETIONARY
AWARD ACTIVITY TYPE: TRAINING/TRAINEESHIP
PERIOD OF PERFORMANCE START DATE: 04/01/2000
PERIOD OF PERFORMANCE END DATE: 12/31/2004

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SUB-OPTIMAL PRE-ESRD CARE AND ITS IMPACT ON OUTCOMES - DESCRIPTION (adapted from the application) The prevalence of end-stage renal disease (ESRD) continues to increase, and mortality among ESRD patients remains high. The principal hypothesis of this proposal is that care of patients with chronic renal failure prior to ESRD (pre-ESRD) is sub-optimal, and this adversely influences outcomes after initiation of ESRD therapy, such as morbidity, mortality and cost. The research will include a macro viewpoint using data from large databases such as the United States Renal Data System (USRDS) and Health Care Financing Administration (HCFA), and a micro viewpoint using detailed primary data collection at a single tertiary care hospital--New England Medical Center (NEMC). USRDS and HCFA files will be used to determine the prevalence and predictors of malnutrition, anemia, late initiation of dialysis and delayed referral to the nephrologist, and their impact on subsequent clinical variables. Separate analyses of pediatric and transplant patients will be undertaken, and compared with dialysis patients. NEMC data will be used to study the impact of delayed nephrology referral and delayed vascular access placement on hospitalization and cost. The results of this proposal are expected to provide important information regarding pre-ESRD care, and for the development of strategies to improve ESRD outcomes. The principal investigator has designed a comprehensive series of studies to evaluate the hypotheses enunciated in this proposal, and is well qualified to carry them through to completion. In addition to a combined fellowship in Adult and Pediatric Nephrology, she holds a Master's degree in Epidemiology. She is mentored by investigators with extensive experience in clinical investigation and advised by a panel of world leaders in epidemiology, clinical trials and health services research. Within a limited time, she and her mentor have put together an infrastructure tailored to achieve the goals of this proposal. The practical experience from the research proposed, and the comprehensive education program outlined are expected to build on the candidate's current skills and experience, and facilitate her transition to an independent investigator in Pediatric and Adult Renal epidemiology.


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: 2004 ( Subtotal = $128,343 )
2004	2004	NEW ENGLAND MEDICAL CENTER HOSPITALS, INC	750 WASHINGTON STREET	BOSTON	MA	02111	SUFFOLK	USA	Kidney Diseases, Urology and Hematology Research	000	5	1/23/2004	NON-COMPETING CONTINUATION	$128,343
														Subtotal = $128,343

Issue Date FY: 2003 ( Subtotal = $128,343 )
2003	2003	NEW ENGLAND MEDICAL CENTER HOSPITALS	171 HARRISON AVENUE, BOX 453	BOSTON	MA	02111	SUFFOLK	USA	Kidney Diseases, Urology and Hematology Research	000	4		NON-COMPETING CONTINUATION	$128,343
														Subtotal = $128,343

Issue Date FY: 2002 ( Subtotal = $128,343 )
2002	2002	NEW ENGLAND MEDICAL CENTER HOSPITALS	171 HARRISON AVENUE, BOX 453	BOSTON	MA	02111	SUFFOLK	USA	Kidney Diseases, Urology and Hematology Research	000	3	2/27/2002	NON-COMPETING CONTINUATION	$128,343
														Subtotal = $128,343

Issue Date FY: 2001 ( Subtotal = $117,421 )
2001	2001	NEW ENGLAND MEDICAL CENTER HOSPITALS	171 HARRISON AVENUE, BOX 453	BOSTON	MA	02111	SUFFOLK	USA	Kidney Diseases, Urology and Hematology Research	000	2	7/17/2001	NON-COMPETING CONTINUATION	$117,421
														Subtotal = $117,421

Issue Date FY: 2000 ( Subtotal = $119,198 )
2000	2000	NEW ENGLAND MEDICAL CENTER HOSPITALS	171 HARRISON AVENUE, BOX 453	BOSTON	MA	02111	SUFFOLK	USA	Kidney Diseases, Urology and Hematology Research	000	1	3/21/2000	NEW	$119,198
														Subtotal = $119,198

Grand Total All Awards = $621,648

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SUB-OPTIMAL PRE-ESRD CARE AND ITS IMPACT ON OUTCOMES

Award Number: K08DK002745

ORGANIZATION: NATIONAL INSTITUTE OF DIABETES & DIGESTIVE & KIDNEY DISEASES

OPDIV: NIH

AWARD CLASS: DISCRETIONARY

AWARD ACTIVITY TYPE: TRAINING/TRAINEESHIP

PERIOD OF PERFORMANCE START DATE: 04/01/2000

PERIOD OF PERFORMANCE END DATE: 12/31/2004

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