PROJECT SUMMARY Over 10% of the world’s population has chronic kidney disease (CKD), and cardiovascular disease is a primary cause of morbidity and mortality. Approximately 50% of patients with advanced CKD die from cardiovascular disease. However, there is limited evidence to inform optimal strategies for prevention and treatment of cardiovascular disease in this population. The pathology of cardiovascular disease may differ in the presence of CKD compared to the general population, and cardiovascular therapy may have distinct risks and benefits. Guidelines on the use of medications to prevent or treat cardiovascular disease in persons with CKD are often unclear or conflicting. The overarching goal of this K24 application is to address major gaps in the evidence surrounding cardiovascular disease development, prevention, and treatment in patients with CKD, providing junior investigators with the rigorous training and mentorship needed in order to advance the field. The candidate, Dr. Morgan Grams, MD PhD, is a nephrologist and epidemiologist with expertise in clinical research methods and a strong track record of successful mentorship. Dr. Grams’s research portfolio provides ample data and opportunity to address clinically important questions at the intersection of cardiovascular disease and CKD, including the molecular basis of cardiovascular prognosis in CKD as well as the safety and effectiveness of approved cardiovascular therapy across the range of kidney function. The K24 will allow Dr. Grams to expand her mentoring to ensure the next generation of patient-oriented researchers are able to take advantage of the ever-growing availability of health care data to complement and enhance pre-clinical work and clinical trials.