The rationale and design of the AASK Cohort Study
The rationale and design of the AASK Cohort Study
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DOI：
10.1097/01.asn.0000070081.15137.c0
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发表时间：
2003-07-01
影响因子：
13.6
通讯作者：
Wright, JT
中科院分区：
文献类型：
--
作者：
Appel, LJ;Middleton, J;Wright, JT
高血压性肾病通常会进展。AASK(非裔美国人肾脏疾病和高血压研究)队列研究的主要目标是前瞻性地确定患有高血压肾病并接受推荐抗高血压治疗的非裔美国人的肾功能进程和肾脏疾病进展的危险因素。AASK队列研究是一项前瞻性观察性研究，是AASK试验的延伸。AASK试验测试了作为初始抗高血压治疗的三种药物(雷米普利、美托洛尔和氨氯地平)和两种水平的血压控制的效果。在1094名试验参与者中，大约650到700名尚未达到ESRD的人可能会参加队列研究。要研究的风险因素包括环境、遗传、生理和社会经济变量。原发肾脏结局是一种综合的临床结局，其定义为血肌酐增加一倍，终末期肾病或死亡。高血压的药物治疗，从血管紧张素转换酶抑制剂雷米普利开始，向所有参与者提供。通过这种方式，这项研究直接控制了肾脏疾病进展的两个主要决定因素：高血压的治疗和肾保护、抗高血压药物的使用。队列研究的最短随访期为5年(总计9至12年，包括AASK试验期间)。最终，来自AASK队列研究的数据应该会加强我们对决定肾脏疾病进展的风险因素和过程的理解。这样的结果可能最终导致延迟或预防ESRD的新战略。
Hypertensive kidney disease commonly progresses. The primary objective of the AASK (African American Study of Kidney Disease and Hypertension) Cohort Study is to determine prospectively the course of kidney function and risk factors for kidney disease progression in African Americans with hypertensive kidney disease who receive recommended anti-hypertensive therapy. The AASK Cohort Study is a prospective, observational study that is an extension of the AASK trial. The AASK trial tested the effects of three medications used as initial anti-hypertensive therapy (ramipril, metoprolol, and amlodipine) and two levels of BP control. Of the 1094 trial participants, approximately 650 to 700 individuals who have not reached ESRD will likely enroll in the Cohort Study. Risk factors to be studied include environmental, genetic, physiologic, and socioeconomic variables. The primary renal outcome is a composite clinical outcome defined by doubling of serum creatinine, ESRD, or death. Medication treatment for hypertension, beginning with the angiotensin converting enzyme inhibitor ramipril, is offered to all participants. In this fashion, the study directly controls two of the major determinants of kidney disease progression: treatment of hypertension and use of renoprotective, anti-hypertensive medication. The minimum duration of follow-up in the Cohort Study is 5 yr (total of 9 to 12 yr, including the period of the AASK trial). Ultimately, data from the AASK Cohort Study should enhance our understanding of the risk factors and processes that determine the progression of kidney disease. Such results might eventually lead to new strategies that delay or prevent ESRD.