Biomarkers for thrombotic risk stratification in nephrotic syndrome
Active Project Grant Awarded Last action
- Award ID
- F32DK149663
- Recipient
-
The Children's Hospital Of Philadelphia UEI G7MQPLSUX1L4
- Awarding agency
-
National Institute of Diabetes and Digestive and Kidney Diseases
National Institutes of Health, Department of Health and Human Services
- Obligated
- $86,824
Award facts
- Assistance listing
- 93.847 Diabetes, Digestive, and Kidney Diseases Extramural Research
- Completion date 0% complete
- Place of performance
- Philadelphia, PA 19104, USA
Award details come from USAspending.gov.
Description
- 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.
Quick answers
Who received award F32DK149663?
F32DK149663 was awarded to The Children's Hospital Of Philadelphia by National Institute of Diabetes and Digestive and Kidney Diseases (National Institutes of Health) on January 8, 2027.
How much is award F32DK149663 worth?
$86,824 has been obligated on F32DK149663.
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