CRIC-Plus: Study of Advanced Chronic Renal Insufficiency

CRIC-Plus：晚期慢性肾功能不全的研究

• 批准号: 7191631
• 负责人: Chi-yuan Hsu
• 金额: $ 86.52万
• 依托单位: UNIVERSITY OF CALIFORNIA, SAN FRANCISCO
• 依托单位国家: 美国
• 财政年份: 2006
• 资助国家: 美国
• 起止时间: 2006-03-01 至 2011-02-28
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7191631
• 关键词: Adult; Affect; Anemia; Cardiovascular Diseases; Cessation of life; Chronic Kidney Insufficiency; Clinical; Cohort Studies; Complement; Condition; Dialysis procedure; Echocardiography; End stage renal failure; Event; Frequencies; Functional disorder; Glomerular Filtration Rate; Goals; Hospitalization; Individual; Inflammation; Intervention; Knowledge; Left ventricular structure; Malnutrition; Measures; Morbidity - disease rate; National Institute of Diabetes and Digestive and Kidney Diseases; Outcome; Patients; Physical Dialysis; Proteinuria; Protocols documentation; Renal function; Research Personnel; Risk; Time; Ventricular; cardiovascular risk factor; cohort; falls; follow-up

DESCRIPTION (provided by applicant): Although chronic renal insufficiency is the precursor to end-stage renal disease, few studies have examined the critical transition from advanced chronic renal insufficiency to end-stage renal disease. Basic and important questions, therefore, remain unanswered. For example: which patients with advanced chronic renal insufficiency are most likely to develop end-stage renal disease? How does cardiovascular disease evolve during the transition from advanced chronic renal insufficiency to end-stage renal disease? How do events and interventions during chronic renal insufficiency affect outcomes after onset of end-stage renal disease? The NIDDK-sponsored Chronic Renal Insufficiency Cohort (CRIC) study, which tracks a large cohort of individuals with chronic renal insufficiency, presents a unique opportunity to fill this important gap in knowledge. In this application, entitled "CRIC-Plus," we propose to intensify the study of patients who develop advanced chronic renal insufficiency and end-stage renal disease. Specifically, for patients whose glomerular filtration rate falls below 20 ml/min/1.73m2, renal function will be assessed every six months, additional echocardiograms at key clinical milestones will be performed and end-stage renal disease related parameters will be recorded. Our specific aims complement and substantially extend the core aims of CRIC. Aim #1: To determine the frequency of progression to end-stage renal disease compared with death from competing causes among patients with glomerular filtration rate below 20 ml/min/1.73m2 and to identify predictors of these different outcomes. Aim #2: To compare left ventricular structure and function when glomerular filtration rate falls below 20ml/min/1.73m2 with left ventricular structure and function at the onset of end-stage renal disease. Aim #3: To compare predicted risks of cardiovascular events, hospitalization and death using exposures measured when glomerular filtration rate falls below 20 ml/min/1.73m2 with predicted risks using exposures measured at the onset of end-stage renal disease. Aim #4: To study the effect of chronic renal insufficiency management, including the timing of dialysis initiation, on clinical outcomes after onset of end-stage renal disease.

描述(申请人提供)：虽然慢性肾功能不全是终末期肾脏疾病的先兆，但很少有研究研究从晚期慢性肾功能不全到终末期肾脏疾病的关键转变。因此，基本和重要的问题仍然没有得到回答。例如：哪些晚期慢性肾功能不全患者最有可能发展为终末期肾脏疾病？从晚期慢性肾功能不全到终末期肾病，心血管疾病是如何演变的？慢性肾功能不全期间发生的事件和干预措施如何影响终末期肾病发病后的预后？ NIDDK赞助的慢性肾功能不全队列(CRIC)研究跟踪了一大批慢性肾功能不全患者，为填补这一重要的知识空白提供了独特的机会。在这项题为“CRIC-Plus”的申请中，我们建议加强对发展为晚期慢性肾功能不全和终末期肾脏疾病的患者的研究。具体来说，对于肾小球滤过率低于20ml/min/1.73m2的患者，将每六个月进行一次肾功能评估，并在关键临床里程碑进行额外的超声心动图检查，并记录终末期肾脏疾病相关参数。我们的具体目标补充并大大扩展了审评委的核心目标。 目的#1：确定肾小球滤过率低于20ml/min/1.73m2的患者进展为终末期肾病的频率与死于其他原因的比率，并确定这些不同结局的预测因素。 目的#2：比较肾小球滤过率降至20ml/min/1.73m2以下时的左室结构和功能与终末期肾病发病时的左室结构和功能。 目的#3：比较当肾小球滤过率降至20ml/min/1.73m2以下时使用暴露量测量的心血管事件、住院和死亡的预测风险与使用终末期肾脏疾病开始时测量的暴露量预测的风险。 目的#4：研究慢性肾功能不全治疗，包括透析开始的时间，对终末期肾病发病后临床结果的影响。