DOI
https://doi.org/10.25772/AJ6X-E033
Defense Date
2023
Document Type
Dissertation
Degree Name
Doctor of Philosophy
Department
Pharmaceutical Sciences
First Advisor
Dayanjan S Wijesinghe
Abstract
Early identification and therapy are essential for preventing the worsening of kidney function. However, the lack of predictive, noninvasive biomarkers has posed a challenge in the diagnosis and management of this prevalent condition. Furthermore, there are barriers to effective treatment that limit our capacity to provide improved health management for individuals with kidney failure. The main objectives are to: Identify the challenges of current biomarkers in kidney disease and propose a metabolomic approach to overcome them by investigating metabolomic alterations associated with the etiology of renal disease, and discuss barriers to optimal care in CKD and discusses the role of data science in improving healthcare. To explore biomarkers and etiology of kidney dysfunction, untargeted lipidomic analysis was performed from a prospective observational cohort of adult kidney transplant patients. To overcome the barriers to optimal care in CKD, an open-source programming language was used to develop and implement an anticoagulant agents platform. Our lipidomic study of kidney transplant patients identified lipid predictors of kidney rejection. This study’ findings show that the lipidome may be used to predict graft function in kidney transplant recipients. A clinical decision support application was developed to provide anticoagulation management guidance. It provides tools for calculating warfarin dosing, and providing anticoagulation methods for individuals with renal impairment. This dissertation also illustrates that lipidomic biomarkers have the potential to provide valuable insights into the health status of patients. Further research is needed to strengthen our lipid biomarker findings and to validate our decision-making tool in real-world practice.
Rights
© The Author
Is Part Of
VCU University Archives
Is Part Of
VCU Theses and Dissertations
Date of Submission
4-5-2023