Cohort Study of Chronic Renal Insufficiency

终末期肾病的发病率、发病率、死亡率和新生儿护理费用每年都在持续上升。此外，与普通人群相比，慢性肾功能不全(CRI)患者患心血管疾病(CVD)的风险约高30倍。该项目建议跟踪3000名CRI患者的队列，以确定与肾功能下降和心血管疾病的发展和进展相关的因素。这将为制定战略以减少CRI和CVD在这一高危人群中的进展奠定基础。该中心组建了一支由经验丰富的研究人员组成的多学科团队，他们在招募和留住长期心血管和肾脏试验的参与者方面拥有有据可查的专业知识。我们中心的另一个优势是覆盖该地区绝大多数医疗保健市场的不同医疗保健系统之间的协作方式(克利夫兰诊所基金会、路易斯·斯托克斯·克利夫兰VAMC、MetroHealth医疗中心、俄亥俄永久医疗集团和克利夫兰大学医院)。已经确定，这些机构中有14,000多名患者的血清肌酐水平已被记录在案，这将使他们有资格参加这项研究。患者身份识别和招募将与当前关于保密的指导方针保持一致。基线评估将包括评估肾功能，以及普遍存在的临床和亚临床心血管疾病。将测量可能导致肾功能不全进展的相关患者、环境和获得医疗保健的相关因素。还将评估传统的心血管危险因素以及与潜在疾病和肾功能障碍相关的因素。中心动脉顺应性的连续测量将在部分患者中进行。患者将每六个月接受一次年度检查和电话采访。提出了肾脏和心血管疾病的临床相关结果。我们经验丰富的研究人员将在留住参与者和确定结果方面发挥重要作用。

The incidence of End Stage Renal Disease, with its attendant morbidity, mortality and neaim care costs continues to rise every year. In addition, the risk of cardiovascular disease (CVD) is approximately 30 times higher in patients with chronic renal insufficiency (CRI) compared to the general population. This project proposes to follow a cohort of 3000 patients with CRI to determine the factors associated with decline in renal function and the development and progression of CVD. This will set the stage to develop strategies to reduce the progression of CRI and CVD in this high-risk population. This center has assembled a multidisciplinary team of experienced investigators with documented expertise in recruitment and retention of participants in long term cardiovascular and renal trials. Another strength of our center is the collaborative approach between the diverse health care systems encompassing the vast majority of the health care market in this area (Cleveland Clinic Foundation, Louis Stokes Cleveland VAMC, Metrohealth Medical Center, Ohio Permanente Medical Group, and University Hospitals of Cleveland). It has already been determined that over 14,000 patients in these institutions have a documented serum creatinine level that would make them eligible for participation in this study. Patient identification and recruitment will be consistent with current guidelines regarding confidentiality. Baseline evaluation will include assessment of renal function, and prevalent clinical and subclinical CVD. Relevant patient, environmental, and access to health care related factors that may contribute to progression of renal insufficiency will be measured. Traditional cardiovascular risk factors, as well as those associated with the underlying disease and renal dysfunction will also be assessed. Serial measurements of central arterial compliance will be performed in a subset of patients. Patients will be followed with annual examinations and phone interviews every six months. Clinically relevant outcomes of renal and cardiovascular disease are proposed. Our experienced research staff will be instrumental in the retention of participants and ascertainment of outcomes.