# Kidney Tubular Injury and Dysfunction and Racial Disparities in Incident Hypertension and Kidney Function Decline

> **NIH NIH P30** · UNIVERSITY OF ALABAMA AT BIRMINGHAM · 2020 · $795,873

## Abstract

PROJECT SUMMARY
The overarching goal of this competitive revision application is to extend the mission of the University of
Alabama at Birmingham-University of California, San Diego O'Brien Center for Acute Kidney Injury (AKI)
Research (P30) by examining factors that contribute to racial disparities in kidney-related health outcomes,
which are disproportionately represented in the Southeastern US. Black Americans are at higher risk for
hypertension (HTN) and chronic kidney disease (CKD) than white Americans. The public health implications
of these disparities are enormous. It is estimated that over half of the elevated risk of heart disease, stroke
and death in black Americans compared with white Americans is attributable to their higher lifetime
prevalence of HTN and CKD. This places prevention of HTN and CKD among the most important public
health priorities for addressing racial disparities in cardiovascular disease and mortality. However, efforts to
develop effective strategies are hampered by a limited understanding of why black Americans experience
higher rates of HTN and CKD. This is particularly important at younger ages because HTN and CKD
manifest earlier in black Americans. Kidney tubules play a central role in the regulation of blood pressure
and glomerular filtration rate (GFR). Tubular atrophy and interstitial fibrosis disrupt numerous biologic
processes related to blood pressure control and glomerular filtration, contributing to the onset of HTN and
GFR decline. Our group and others have shown that serum and urine measures of tubule health associate
with the development of HTN and CKD progression in select populations. Further, in older age groups, we
have preliminary data that suggest black adults have greater tubular injury and dysfunction than white
adults as measured by serum and urine markers. However, these prior studies were limited by focusing on
older populations or those with established co-morbidities, making it unclear how tubular injury may develop
in younger, healthier adults, and whether early damage to the kidney tubules contributes to the
disproportionate development of HTN and CKD in black as compared to white adults. The Coronary Artery
Risk Development in Young Adults (CARDIA) Study provides an ideal opportunity to examine associations
of markers of kidney tubule health with the development of HTN and CKD in younger adults, and recruited
participants in the Southeast US, among other areas. The goals of this application are to (1) determine
racial differences in biomarkers of kidney tubule injury and dysfunction and to identify whether unique
patterns of kidney damage are more common in black than in white adults; (2) examine the association of
novel markers of kidney tubule health with risk of incident HTN and rapid eGFR decline; and (3) quantify the
contribution of abnormalities in kidney tubule health to the observed racial disparities in HTN and CKD
among CARDIA participants. This competitive revision applicat...

## Key facts

- **NIH application ID:** 10164036
- **Project number:** 3P30DK079337-13S1
- **Recipient organization:** UNIVERSITY OF ALABAMA AT BIRMINGHAM
- **Principal Investigator:** ANUPAM AGARWAL
- **Activity code:** P30 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2020
- **Award amount:** $795,873
- **Award type:** 3
- **Project period:** 2008-09-01 → 2023-07-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10164036

## Citation

> US National Institutes of Health, RePORTER application 10164036, Kidney Tubular Injury and Dysfunction and Racial Disparities in Incident Hypertension and Kidney Function Decline (3P30DK079337-13S1). Retrieved via AI Analytics 2026-05-24 from https://api.ai-analytics.org/grant/nih/10164036. Licensed CC0.

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