A Mentoring Program in Kidney Care for Older Adults

PROJECT SUMMARY/ABSTRACT This proposal for a Midcareer Investigator Award in Patient-Oriented Research (K24) will support the research program of Dr. Manjula Kurella Tamura, a nephrologist at Stanford University and Director of the Veterans Affairs Palo Alto Geriatric Research and Education Clinical Center. The candidate leads a multi-disciplinary research program which is focused on patient-centered outcomes of dialysis treatment in older adults. Her research program, comprised of a health services component and an interventions component, has been supported by five federally funded awards during the past five years, and has produced an extensive portfolio of work to support hypothesis driven mentee research. During this time, the candidate’s research program has provided training opportunities for 13 junior investigators who have successfully obtained funding, published research in high-impact journals, and transitioned into academic positions. In this K24 application, her overarching goal is to grow and sustain this program by: (1) enhancing her skills as a research mentor by obtaining training in key areas, and (2) using her research as a platform to mentor trainees from a range of disciplines, and (3) extending her research to evaluate treatment trade-offs earlier in the course of kidney disease. Recent clinical trials demonstrate that intensive versus standard blood pressure targets reduce mortality and cardiovascular events, but at the expense of kidney function. The scientific goal of this application is to evaluate the comparative harms and benefits of intensive versus standard hypertension treatment and hypertension deprescribing on kidney end-points in two real world older adult cohorts. The secondary goal is to demonstrate the application of novel analytical approaches that extend causal effects from randomized trials to older and sicker populations. The candidate’s mentoring program will integrate resources from the breadth of training programs at Stanford and VA Palo Alto, with unique opportunities tailored to the career development of scientists in aging research.