BERNARD G. JAAR, M.D.
Research Interests
Dr. Jaar is interested in the conduct of epidemiologic studies in the field of end-stage renal disease and its related complications. His personal research interest is currently focused on outcome studies of peripheral arterial disease (PAD) in end-stage renal disease (ESRD) patients and morbidity and mortality of ESRD patients by dialysis modality. In addition to leading the Cardiovascular Endpoint Committee of the CHOICE study, he is involved in several research projects within the Division of Nephrology and also at the Welch Center for Prevention, Epidemiology and Clinical Research, and the Department of Environmental Health at the School of Public Health.
Current Research Projects:
1. Infections in dialysis patients: With Dr. Briggs in the Division of Nephrology and Dr. Powe at the Welch Center for Prevention, Epidemiology and Clinical Research, Dr. Jaar analyzed data from the United States Renal Disease System and reported on the incidence, risk factors and prognosis associated with septicemia in dialysis patients comparing hemodialysis and peritoneal dialysis patients. This is the first study describing the epidemiology of septicemia in a nationally representative sample of the U.S. dialysis population. Dr. Jaar's group also reported on the incidence, risk factors and prognosis associated with septicemia comparing diabetic and non-diabetic hemodialysis patients. He is currently conducting an analysis of pulmonary infections in hemodialysis patients.
2. Cohort study of peripheral arterial disease (PAD) in dialysis patients: burden, risks, and prognosis: With Drs. Coresh and Powe (Welch Center) and using the Choices for Healthy Outcomes In Caring for ESRD (CHOICE) Study, Dr. Jaar conducted a cross-sectional analysis of the association between the novel cardiovascular risk factors [CRP, Lp(a)] and PAD in dialysis patients. This work was presented at the American society of Nephrology 2002.
Future Research Projects:
Future research areas in this field will include the following aims to systematically study established [e.g., age, diabetes] and novel [CRP, Lipoprotein (a)] risk factors and consequences of clinically manifest PAD in the CHOICE study.
A. Prospectively study traditional and novel cardiovascular risk factors for the incidence of PVD procedures over a 7-year follow-up period.
B. Prospectively analyze limb survival and patient survival following lower extremity revascularization and amputation.
C. Prospectively investigate changes in generic and disease-specific quality of life of dialysis patients at baseline and following PVD procedures.
3. Study of morbidity and morality between hemodialysis and peritoneal dialysis patients: With Drs. Coresh, Klag and Powe (Welch Center) and using the Choices for Healthy Outcomes In Caring for ESRD (CHOICE) Study, Dr. Jaar conducted a prospective study looking at the association between dialysis modality and dialysis patients’ survival. This work has been presented at the American Society of Nephrology 2003 and published in the Annals of Internal Medicine in August 2005.
4. An International Comparison of Mortality in Two Prospective Cohorts of Incident Dialysis Patients in the U.S. and France: CHOICE and EPIREL: with Dr. Luc Frimat from the Division of Nephrology of the University Hospital Nancy, France. This is an international study comparing outcomes of incident dialysis patients between the U.S. and France. Preliminary results were presented at the 2002 American society of Nephrology meeting 2002. The manuscript is currently under review.
5. Risk Factors for Chronic Kidney Disease: A Prospective Study of 23,534 Men and Women in Washington County, Maryland: with Dr. Melanie Haroun from the Division of Nephrology and Dr. Josef Coresh from the Welch Center for Prevention, Epidemiology and Clinical Research. This is a prospective study of the risk factors for chronic kidney disease among 23,534 men and women in Washington County, Maryland. Preliminary results of the research project were presented at the 2001 and 2002 American society of Nephrology meetings. The initial manuscript has been published in the Journal of the American Society of Nephrology in 2003.
6. Co-Investigator of KOREA II: with Dr. Virginia Weaver (P.I.) from the Department of Environmental Health, Johns Hopkins Bloomberg School of Public Health. This is a prospective study of Korean lead workers and we will study their environmental and associated genetic risk factors for worsening renal function.
Selected Publications:
1. Powe RN, Jaar B, Furth S, Hermann J, Briggs W. Septicemia In Dialysis Patients: Incidence, Risk Factors And Prognosis. Kidney International 1999; 55 (3): 1081-1090.
2. Jaar B, Hermann J, Furth S, Briggs W, Powe RN. Septicemia In Diabetic Hemodialysis Patients: Comparison Of Incidence, Risk Factors And Mortality With Non-Diabetic Hemodialysis Patients. American Journal Of Kidney Diseases 2000; 35 (2): 282-292.
3. Jaar BG, Kim HS, Samaniego MD, Lund GB, Atta MG. Percutaneous Mechanical Thrombectomy: A New Approach In The Treatment Of Acute Renal Vein Thrombosis. Nephrology Dialysis Transplantation 2002; 17 (6): 1122-1125.
4. Haroun MK, Jaar BG, Hoffman SC, Comstock GW, Klag MJ, Coresh J. Risk Factors for Chronic Kidney Disease: A Prospective Study of 23,534 Men and Women in Washington County, Maryland.
Journal of the American Society of Nephrology 2003; 14: 2934-2941.
5. Boulware EL, Jaar BG, Tarver-Carr ME, Brancati FL, Powe NR. Screening for Proteinuria in U.S. Adults: A Cost-effectiveness Analysis. JAMA 2003; 290 (23): 3101-3114.
6. Jaar BG, Astor BC, Berns JS, Powe NR. Predictors of amputation and survival following lower extremity revascularization in hemodialysis patients. Kidney International 2004; 65: 613-620.
7. Liu Y, Coresh J, Eustace JA, Longenecker JC, Jaar B, Fink NE, Tracy RP, Powe NR, Klag MJ. Association between cholesterol and mortality in dialysis patients: Role of inflammation and malnutrition. JAMA 2004; 291: 451-459
8. Boulware EL, Jaar BG, Powe NR. Cost-effectiveness of Screening for Proteinuria—Reply.
JAMA 2004; 291: 1443.
9. Wu J, Jaar BG, Briggs WA, Choi MJ, Kraus ES, Racusen LC, Atta MG, Samaniego MD. High dose mycophenolate mofetil in the treatment of post-transplant glomerular disease in the allograft: a case series. Nephron Clinical Practice 2004; 98 (3): c61-c66.
10. Plantinga LC, Fink NE, Jaar BG, Sadler JH, Coresh J, Klag MJ, Levey AS, Powe NR. Frequency of Sit-down Patient Care Rounds, Attainment of Clinical Performance Targets, Hospitalization, and Mortality in Hemodialysis Patients. Journal of the American Society of Nephrology 2004; 15: 3144-3153.
11. Weaver VM, Jaar BG, Schwartz BS, Todd AC, Ahn K-D, Lee S-S, Wen J, Parson PJ, and Lee B-K. Associations among lead dose biomarkers, uric acid, and renal function in Korean lead workers. Environmental Health Perspectives 2005; 113 (1): 36-42.
12. Plantinga LC, Jaar BG, Fink NE, Sadler JH, Coresh J, Klag MJ, Powe NR. Frequency of Patient-Physician Contact in Chronic Kidney Disease Care and Achievement of Clinical Performance Targets. International Journal for Quality in Health Care 2005; 17 (2): 115-121.
13. Melamed ML, Kim HS, Jaar BG, Molmenti E, Atta MG, Samaniego M. Combined Percutaneous Mechanical and Chemical Thrombectomy for Renal Vein Thrombosis in Kidney Transplant Recipients. American Journal of Transplantation 2005; 5 (3): 621-626.
14. Weaver VM, Lee B-K, Todd AC, Jaar BG, Ahn K-D, Wen J, Shi W, Parson PJ, and Schwartz BS. Associations of patella lead and other lead biomarkers with renal function in lead workers. Journal of Occupational and Environmental Medicine 2005; 47 (3): 235-243.
15. Longenecker JC, Klag MJ, Marcovina SM, Liu YM, Jaar BG, Powe NR, Fink NE, Levey AS, Coresh J. High lipoprotein(a) levels and small apolipoprotein(a) size prospectively predict cardiovascular events in dialysis patients. Journal of the American Society of Nephrology 2005; 16: 1794-1802.
16. Jaar BG, Coresh J, Plantinga LC, Fink NE, Klag MJ, Levey AS, Levin NW, Sadler JH, Kliger A, Powe NR. The Risk of Death with Peritoneal Dialysis versus Hemodialysis in a National Cohort of Patients with Incident End-Stage Renal Disease. Annals of Internal Medicine 2005; 143: 174-183.
17. Plantinga LC, Pham HH, Fink NE, Rubin HR, Jaar BG, Powe NR. Use of Dialysis Educators beyond Nurses and Physicians and Outcomes in Patients with Kidney Failure. Advances in Chronic Kidney Disease 2005; 12 (4): 424-432.
18. Weaver VM, Schwartz BS, Jaar BG, Ahn KD, Todd AC, Lee SS, Kelsey KT, Silbergeld EK, Lustberg ME, Parsons PJ, Wen J, Lee BK. Associations of uric acid with polymorphisms in the delta-aminolevulinic acid dehydratase, vitamin D receptor, and nitric oxide synthase genes in Korean lead workers. Environmental Health Perspectives 2005; 113 (11):1509-1515.
