Cardiovascular risk reduction in adolescents and young adults with kidney disease

Project Abstract I am a dual-trained adult and pediatric nephrologist and I have been conducting patient-oriented research (POR) in cardiovascular disease (CVD) for the last decade. My POR program is focused on hypertension, cardiovascular outcomes, and health disparities in patients with kidney disease. I am currently Director of the

Master’s in Clinical and Epidemiologic Research Program at University of California San Francisco (UCSF) in the Department of Epidemiology and Biostatistics, and I am also co-PI of a joint multi-institutional nephrology, urology, and hematology research training program which spans UCSF, Stanford, UC Davis, and UC Berkeley.

Thus, I have access to a large number of trainees who are interested in POR and who would benefit from dedicated mentorship to ensure their success in cardiovascular-focused clinical research. My research program provides unique opportunities for the training of early-stage investigators who are interested in

pursuing POR in CV topics given its depth and multi-disciplinary nature. Our infrastructure includes >30 datasets and access to national data registries and electronic health record data that can facilitate the design of mentee projects and research training within NHLBI mission areas. The training environment at UCSF is

stellar and bolsters a variety of resources that are available to mentees through our Clinical and Translational Science Award, K Scholars Program, as well as state-of-the-art electronic health record (EHR) databases and tools that have been developed to allow researchers to leverage natural language processing when working

with EHR data. Cardiovascular disease remains the leading cause of death in adolescents and young adults with a history of kidney disease, but cardiovascular risk factor control remains suboptimal in these populations. The objectives of this proposal are to elucidate patterns of cardiovascular disease risk in adolescent and young

patients with kidney disease, understand barriers to the implementation of guideline-recommended therapies and the achievement of ideal CV health in young adult populations, and test the acceptability and clinical yield of novel digital blood pressure monitoring tools using remote study designs in the young adult population. The

proposed work will provide a platform to support opportunities for mentees interested in POR in CVD and facilitate learning experiences in the use of electronic health record data for research, natural language processing, machine learning, mixed methods, and digital health/remote study designs. My mentoring aims

are to 1) hone my mentorship and leadership skills; 2) gain formal training in the mentorship of mentees who are underrepresented in medicine and research; 3) expand my capacity to mentor trainees in topics such as big data, natural language processing, and digital health; 4) receive guidance and feedback from a group of

experienced mentors on my K24 advisory committee. Given my numerous responsibilities, this award will support the time needed for me to focus on mentoring advanced trainees in POR in CVD and refine my skills in mentorship, which would otherwise not be possible given my current clinical and administrative obligations.