Continuation of the Coordinating Center for the Chronic Renal Insufficiency Cohort (CRIC) Study

这是宾夕法尼亚大学临床流行病学和生物统计学中心的一份申请， vania作为科学和数据协调中心（SDCC），继续开展慢性肾脏病研究。 不充分队列研究（CRIC）。慢性肾功能不全影响着超过2000万美国人， 老年人的负担。与慢性肾脏疾病（CKD）相关的发病率来自于频繁的 进展为终末期肾病（ESRD），心血管事件的风险不成比例，以及其他 与残疾有关的疾病和高昂的护理费用。 自2001年启动以来，审评委的研究招募并跟踪了一批种族和族裔多样的人群 来自美国13个临床招募中心的5,000多名肾功能减退的参与者。的 CRIC的最初目的是建立一个临床研究实验室，旨在（a）确定新的预测因子， CKD进展，和（B）表征心血管疾病的表现并识别其风险因素 在CKD患者中。CRIC研究检查了一系列广泛的病因因素（临床、非传染性疾病、 口服和生物标志物相关）可能导致进展性CKD和发病率 尤其是那些在CKD病程早期进行手术的患者，此时可能会阻止进展。Charac- 明确这些危险因素和结果之间的关系将有助于识别高风险亚组 指导CKD预防性治疗试验的入组和预防性治疗的应用。超过 时间，科学重点和审评委调查员网络通过一个高度可持续的 该项目包括90个项目，其中大部分是联邦资助的。迄今为止，审评委 研究的调查活动已经导致了150多篇发表的科学论文，还有许多其他的人， 在CKD背景下解决临床结局的开发中的论文。 为了最大限度地利用这一独特的科学资源所固有的机会，审评委的研究将在下一阶段， 采取多方面的战略，包括：（a）继续对这一组进行跟踪，并调查一个广泛的领域， 利用最先进的方法， 生物统计学和生物信息学;（B）使用新的远程数据收集技术来确定 肾功能和心血管风险亚表型;（c）与CRIC临床中心定期共享数据， 促进新的合作伙伴关系，促进创新的科学研究，并支持专业发展， （d）便利经常和定期审查审评委数据的传播分析， 对NIDDK数据存储库进行主动更新，补充存储库的用户支持活动，以及 （e）协调审评委的目标和活动 与肾脏精准医学项目和其他NIH赞助的项目进行研究;以及（f）建立 为审评委研究工作以外的调查人员管理一个机会资金池。

This is an application from the Center for Clinical Epidemiology and Biostatistics at the University of Pennsyl- vania to serve as the Scientific and Data Coordinating Center (SDCC) for the continuation of the Chronic Renal Insufficiency Cohort (CRIC) Study. Chronic renal insufficiency affects over 20 million Americans with particular burden among older adults. The morbidity associated with chronic kidney disease (CKD) derives from frequent progression to end-stage renal disease (ESRD), a disproportionate risk of cardiovascular events, and other morbidities associated with disability and high costs of care. Since its inception in 2001, the CRIC Study has recruited and followed a racially and ethnically diverse cohort of over 5,000 participants with reduced kidney function from 13 clinical recruitment sites across the US. The original aim of CRIC was to establish a clinical research laboratory designed to (a) identify novel predictors of CKD progression, and (b) characterize the manifestations of cardiovascular disease and identify its risk factors among individuals with CKD. The CRIC Study has examined a broad set of etiological factors (clinical, behav- ioral, and biomarker-associated) potentially responsible for both progressive CKD and morbidities in the setting of CKD, especially those operating early in the course of CKD when progression may be forestalled. Charac- terizing relationships between these risk factors and outcomes will permit identification of high-risk subgroups with CKD, guiding enrollment into preventive treatment trials and application of preventive therapies. Over time, the scientific focus and the CRIC investigator network have broadened extensively through a highly suc- cessful ancillary studies program that has included 90 projects, mostly federally funded. To date, the CRIC Study's investigative activities have resulted in over 150 published scientific papers with many additional man- uscripts in development addressing clinical outcomes in the setting of CKD. To maximize the opportunities inherent in this unique scientific resource, the CRIC Study will, in its next phase, pursue a multifaceted strategy involving: (a) continued follow-up of the cohort and investigation of a broad ar- ray of factors associated with the progression and consequences of CKD utilizing state-of-the-art methods in biostatistics and bioinformatics; (b) the use of novel remote data collection techniques to identify trajectories of kidney function and cardiovascular risk sub-phenotypes; (c) regular data sharing with CRIC Clinical Centers to facilitate new collaborative partnerships, promote innovative scientific inquiry, and support professional devel- opment of CKD researchers; (d) facilitating disseminated analysis of CRIC data by frequent and comprehen- sive updates to the NIDDK Data Repository, supplementation of the Repository's user support activities, and robust outreach to the broader research community; (e) coordination of the goals and activities of the CRIC Study with the Kidney Precision Medicine Project and other NIH-sponsored projects; and (f) the establishment and administration of an Opportunity Pool of funds for investigators external to the CRIC study.