Chronic Kidney Disease Prognosis Consortium

项目摘要/摘要 慢性肾脏病(CKD)是一种全球公共卫生流行病，影响着10%-16%的成年人口 在亚洲、欧洲和北美。慢性肾脏病的临床影响是巨大的：终末期肾病的风险 终末期肾病(ESRD)、心血管疾病(CVD)和过早死亡率都会增加，但CKD的选择 预防和治疗仍然有限。 建议的研究是对R01 DK100446的更新，R01 DK100446是一项资助CKD预测联盟的赠款 (CKD-PC)。CKD-PC成立于2009年，现在包括来自70多个参与者的1100万名参与者的数据 来自40个国家和地区的队列，在进行高影响荟萃分析方面有着良好的记录(《新英格兰医学杂志》2篇， 柳叶刀3例，JAMA 4例，BMJ 1例，肾脏Int 4例，JASN 2例，AJKD 2例，柳叶刀糖尿病内分泌1例)。 CKD-PC通过代表广泛的全球人口，补充了CKD中已建立的队列； 跨越全方位肾功能；坚持不懈地关注协调，探索 异质性和校准；以及在适当情况下的荟萃分析结果。 在这一新的资助期内，我们将继续指导和招募来自世界各地的调查人员和队伍 世界，大幅增长和创新，并在以下目标中有新的重点领域： 目的1.确定与临床标记物相关的慢性肾脏病事件和进展的风险。 患者群体的范围。 目的2.评估与表皮生长因子受体和蛋白尿相关的非肾脏结局的风险。 目的3.开发CKD发病率、CKD进展和终末期肾病的总体和具体风险计算器 例如心力衰竭患者。 在所有目标中，我们将继续实施和扩展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。我们保持灵活性 并有效应对指南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)和主要社会 (例如，国际肾脏学会、国家肾脏基金会和美国肾脏学会) 以及告知全球健康指标和经济努力(例如，健康指标研究所和 评估全球疾病负担)。我们的首要目标是促进理解、关怀和 CKD患者和全球人群的结果，使用由研究人员领导的全球联盟和数据 和来自约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.