Chronic Kidney Disease Prognosis Consortium

项目总结/摘要 慢性肾脏病（CKD）是一种全球性的公共卫生流行病，影响10-16%的成年人口 在亚洲、欧洲和北美。CKD的临床影响是巨大的：终末期肾病的风险 （ESRD）、心血管疾病（CVD）和过早死亡率都有所增加，但CKD的选择 预防和治疗仍然有限。 这项拟议的研究是R 01 DK 100446的延续，该研究是CKD预后联盟的一项资助。 （CKD-PC）。CKD-PC成立于2009年，现在包括来自70多个国家的超过1100万参与者的数据。 跨越40个国家的队列，具有产生高影响力荟萃分析的良好记录（2个在NEJM， 3篇在Lancet中，4篇在JAMA中，1篇在BMJ中，4篇在Kidney Int中，2篇在JAMA中，2篇在AJKD中，1篇在Lancet Diabetes Endocrinol中）。 CKD-PC通过代表广泛的全球人群，补充了CKD中已建立的队列; 跨越肾功能的全方位，执着于和谐，探索 异质性和校准;以及在适当时对结果进行荟萃分析。 在这个新的资助期内，我们将继续指导和招募来自世界各地的研究人员和队列。 世界，大幅增长，并在以下目标的新重点领域进行创新： 目标1.确定CKD事件和CKD进展与临床标志物相关的风险， 患者人群的范围。 目标2.评价与eGFR和白蛋白尿相关的非肾脏结局风险。 目标3.开发CKD发病率、CKD进展和ESRD总体和具体风险计算器 如心力衰竭患者。 在所有的目标，我们将继续实施和扩大我们的创新荟萃分析方法， 包括马尔可夫过程、模拟和竞争风险的标准合并。我们仍然保持灵活 并且有效地响应由指导组织提出的高优先级主题（例如，肾脏疾病： 改善全球成果）、监管机构（例如，美国食品和药物管理局）和主要学会 (e.g.,国际肾病学会、国家肾脏基金会和美国肾病学会） 以及告知全球健康度量和经济努力（例如，卫生研究所 全球疾病负担评估）。我们的首要目标是促进理解，关心， CKD患者和全球人群的结局，使用一个由联合国领导的全球联盟和数据， 来自约300名国际合作者的专业知识。

PROJECT SUMMARY/ABSTRACT Chronic kidney disease (CKD) is a global public health epidemic, affecting 10-16% of the adult population in Asia, Europe, and North America. The clinical impact of CKD is substantial: risks of end stage renal disease (ESRD), cardiovascular disease (CVD), and premature mortality are all heightened, but options for CKD prevention and treatment remain limited. The proposed study is a renewal of R01 DK100446, a grant which funds the CKD Prognosis Consortium (CKD-PC). CKD-PC was formed in 2009 and now includes data on >11 million participants from more than 70 cohorts spanning 40 countries with a strong track record of producing high impact meta-analyses (2 in NEJM, 3 in Lancet, 4 in JAMA, 1 in BMJ, 4 in Kidney Int, 2 in JASN, 2 in AJKD, and 1 in Lancet Diabetes Endocrinol). CKD-PC complements established cohorts in CKD by representing a broad range of global populations; spanning the full range of kidney function; devoting tenacious attention to harmonization, exploration of heterogeneity, and calibration; and meta-analyzing results where appropriate. In this new funding period, we will continue to mentor and recruit investigators and cohorts from around the world, grow substantially, and innovate with new areas of emphasis in the following aims: Aim 1. To determine risk of incident CKD and CKD progression associated with clinical markers across a range of patient populations. Aim 2. To evaluate the risk of non-kidney outcomes associated with eGFR and albuminuria. Aim 3. To develop risk calculators for CKD incidence, CKD progression, and ESRD overall and in specific populations such as patients with heart failure. In all aims, we will continue to implement and expand upon our innovative meta-analysis methods, including Markov processes, simulations, and standard incorporation of competing risks. We remain flexible and efficient in responding to high priority topics set forth by guideline organizations (e.g., Kidney Disease: Improving Global Outcomes), regulatory agencies (e.g., US Food and Drug Administration) and major societies (e.g., International Society of Nephrology, National Kidney Foundation, and American Society of Nephrology) as well as informing global health metrics and economic efforts (e.g., Institute for Health Metrics and Evaluation Global Burden of Disease). Our overarching goal is to advance the understanding, care, and outcomes of CKD patients and global populations, using an investigator-led global consortium and the data and expertise from ~300 international collaborators.