Potential Research Opportunity for Internal Medicine Housestaff

Mentor: Robert Toto, Jula Inrig
Department: Medicine - Nephrology
Room number:
Mail Code: 8856
Phone number: 214-648-2516
E-mail: jula.inrig@utsouthwestern.edu
Project title: Blood Pressure, endothelial cell dysfunction and outcomes in dialysis patients

Human subjects IRB approved project number (where applicable): 102008-042

Animal subjects IRB approved project number (where applicable): n/a

Project Type (patient-based research, animal-based research, or basic research; this characterization is only to permit a general classification for grouping similar types of projects) Patient based

Brief Description of Project:

The specific aims of this project are as follows:
1. To demonstrate in a national hemodialysis cohort that increasing blood pressure during hemodialysis is associated with increased cardiovascular morbidity and mortality;
2. Recruit 50 maintenance hemodialysis patients including 25 with intradialytic hypertension and 25 controls to determine the relationship between intradialytic hypertension and a) endothelial cell function measure by endothelial progenitor cells and flow mediated dilation; b) vascular compliance measure by pulse wave velocity; and c) time-averaged blood pressure burden measured by 44-hour interdialytic ambulatory blood pressure
3. Conduct a pilot study in 25 maintenance hemodialysis patients with intradialytic hypertension to determine whether chronic administration of carvedilol at a dose of 50 mg daily will improve surrogate markers of cardiovascular outcomes including: endothelial progenitor cells, flow mediated vasodilation, pulse wave velocity, and blood pressure.

Previous Research Activities or Publications of J.I. with Housestaff:

This is a representative list of publications during my faculty time at Duke. I (J.I.) transferred to UTS 9/1/2008.

1. Inrig JK, Reed S, Szczech LA, Engemann J, Friedman JY, Corey RC, Schulman K, Reller LB, Fowler VG. Relationship between Clinical Outcomes and Vascular Access Type among Hemodialysis Patients with Staphylococcus aureus Bacteremia Clin J Am Soc Nephrol, 1: 518-524, 2006.

2. Inrig JK, Sun JL, Yang Q, Briley LP, Szczech LA. Mortality by Dialysis Modality among ESRD Patients Awaiting Renal Transplantation. Clin J Am Soc Nephrol, 1:774-779, 2006.

3. Stryjewski E, Szczech LA, Benjamin DK, Inrig JK, Kanafani ZA, Engemann JJ, Chu VH, Reller LB, Corey GR, Fowler, VG. Use of Vancomycin or First Generation Cephalosporins in the Treatment of Hemodialysis-dependent Patients with Methicillin-Susceptible Staphylococcus aureus Bacteremia. CID, 44:190-196,2007.

4. Inrig JK, Patel UD, Gillespie BS, Hasselblad V, Himmelfarb J, Reddan D, Lindsay RM, Winchester JF, Stivelman J, Toto R, Szczech LA. Relationship between Interdialytic Weight Gain and Blood Pressure in Hemodialysis Patients. Am J Kidney Disease, 50(1):108-118.e1-4, 2007.

5. Inrig JK, Oddone EZ, Hasselblad V, Gillespie B, Patel UD, Reddan D, Toto R, Himmelfarb J, Winchester JF, Stivelman J, Lindsay RM, Szczech LA. Association of Intradialytic Blood Pressure Changes with Hospitalization and Mortality Rates in Prevalent ESRD Patients. Kidney International, 71:454-561, 2007.

6. Inrig JK, Gillepie BS, Briley LP, Patel UD, She L, Easton JD, Topol E, Szczech LA. Risk of Cardiovascular Outcomes among Subjects with Atherosclerotic Cardiovascular Disease and Greater than Normal estimated Glomerular Filtration Rate. Clin J Am Soc Nephrol, 2(6):1215-22, 2007

7. Inrig JK, Patel UD, Briley LP, She L, Gillespie B, Easton JD, Topol E, Szczech LA. Mortality, Kidney Disease, and Cardiac Procedures following Acute Coronary Syndrome. Nephrology Dialysis Transplantation, 23:934-940, 2008

8. Szczech LA, Barnhart H, Inrig JK, Reddan D, Sapp S, Califf RM, Patel UD, Singh AJ. Secondary analysis of the CHOIR trial: epoetin- dose and achieved hemoglobin outcomes. Kidney International; 74:791-798, 2008

9. Ellis MJ, Parikh CR, Inrig JK, Kambay M, Patel UD. Chronic Kidney Disease after Hematopoietic Cell Transplantation: a Systematic Review. American Journal Transplantation;8:2378-2390, 2008.

10. Li Y, Friedman JY, O'Neal BF, Hohenboken MJ, Griffiths RI, Stryjewski ME, Middleton JP, Schulman KA, Inrig JK, Fowler VF, Reed SD. Outcomes of Staphylococcus aureus infection in Hemodialysis-Dependent Patients. cJASN, in press