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Research On Cocaine-related Renal Disease To Benefit From NIH Stimulus Funding

A Medical College of Georgia nurse researcher is among the first in the nation to receive National Institutes of Health stimulus funding through the American Recovery and Reinvestment Act of 2009. The two-year, $147,000 grant will support at least three jobs and the research of African-Americans in the Augusta community who may suffer from cocaine-related renal disease. The recovery act seeks to create or save more than 3.5 million jobs over the next two years. "It"s the realization of a long-time dream to launch my research career and help medically underserved communities," says Dr. Beth NeSmith, assistant professor of physiological and technological nursing in the MCG School of Nursing and the grant"s principal investigator. The National Institute on Drug Abuse funding also will support Stacey Crawford, a research assistant and study coordinator whose previous funding was withdrawn following the relocation of a research faculty member, and Dr. Rosalind Jones, an assistant professor of health environments and systems, who will serve as a grant sub-investigator. The multidisciplinary research team also includes three MCG School of Medicine faculty members: Dr. Peter Buckley, chair of the Department of Psychiatry and Health Behavior, Dr. Harold Szerlip, professor in the Sections of Nephrology, Hypertension and Transplantation Medicine and Pulmonary Disease, and Dr. John Catravas, director of the MCG Vascular Biology Center and senior associate dean for basic science research. According to the U.S. Department of Health and Human Services, cocaine is the most frequently reported illicit drug associated with drug-related deaths, and African-Americans are disproportionately affected. Dr. NeSmith hypothesizes that cocaine use, which can cause increased inflammation and lead to heart and lung disease, might contribute to renal disease in African-Americans, a group that is already at a disproportionately high risk for the disease. "Studies have shown that cocaine can affect organ function, but the specific effect on renal function has not been well-established," Dr. NeSmith says. She will compare urine levels of microalbuminuria, a biomarker for early renal disease, in a group of cocaine-dependent African-Americans to a control group who don"t use the drug. "If cocaine-dependent African-Americans have occult renal disease that not been clinically identified yet, that would make a difference when deciding a treatment plan," Dr. NeSmith says. Some drugs used to treat cocaine addiction have adverse effects on the kidneys, so it"s important to know if a patient suffers from asymptomatic renal disease. If that"s the case, alternative drug doses or treatments could be used. The study also will examine the relationship between microalbuminuria levels with blood levels of several inflammation biomarkers. Inflammation is linked to chronic stress, which poses another setback for this patient population by making them increasingly susceptible to organ failure, especially after trauma. "Many people who are involved in trauma are also substance abusers," Dr. NeSmith says. "If we"re able to identify a population with sub-clinical renal problems before potentially life-threatening trauma occurs, treatment can be tailored to the patient"s physiology by keeping all existing comorbidities in mind." The findings of this pilot study will be used to develop further studies focused on early diagnosis and treatment of cocaine-related complications to reduce morbidity, Dr. NeSmith says Paula Hinely Medical College of Georgia


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