Pulse wave velocity in chronic kidney disease

慢性肾脏病的脉搏波速度

• 批准号: 7497695
• 负责人: Raymond R Townsend
• 金额: $ 12.19万
• 依托单位: UNIVERSITY OF PENNSYLVANIA
• 依托单位国家: 美国
• 财政年份: 2005
• 资助国家: 美国
• 起止时间: 2005-05-01 至 2010-04-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7497695
• 关键词: Address; Adult; Amputation; Aorta; Appearance; Biometry; Blood Circulation; Blood Pressure; Blood Vessels; Cardiovascular Diseases; Cardiovascular system; Cessation of life; Chronic Kidney Failure; Chronic Kidney Insufficiency; Clinical; Cohort Studies; Creatinine; Critiques; Data; Development; Devices; Diabetes Mellitus; Dialysis patients; Dialysis procedure; Diastolic blood pressure; Dietary Proteins; Disease; Disease Outcome; Disease Progression; Drug usage; Elderly; End Point; Enrollment; Epidemiology; Etiology; Event; Future; Glomerular Filtration Rate; Goals; Heart Diseases; Heart failure; Impairment; Individual; Institutes; Intake; Intervention; Invasive; Iothalamate; Kidney; Kidney Diseases; Kidney Failure; Kidney Transplantation; Lower Extremity; Measurement; Measures; Modeling; Morbidity - disease rate; Outcome; Patients; Physical Dialysis; Physiologic pulse; Population; Preventive; Procedures; Proteinuria; Pulse Pressure; Pulse taking; Rate; Recruitment Activity; Renal function; Reproducibility; Research Personnel; Risk; Risk Factors; Role; Serum; Severities; Site; Standards of Weights and Measures; Stroke; Subgroup; Techniques; Testing; Time; Travel; base; cohort; experience; hypertension treatment; improved; indexing; mortality; predictive modeling; programs; treatment trial

The National Institute of Diabetes, Digestive, and Kidney Diseases (NIDDK) established the Chronic Renal Insufficiency Cohort Study in 2001. The principal goals of the CRIC Study are to examine risk factors for chronic kidney disease (CKD) progression (i.e. further loss of kidney function) and cardiovascular events among patients with varying severity of CKD, and develop predictive models that will identify high-risk subgroups with CKD. The latter results will target enrollment of high-risk subjects into future treatment trials and increase application of available preventive therapies. Hypertension treatment has been the most effective intervention altering the course of renal function loss in CKD. However, the drugs used in the treatment of hypertension differ in their benefits on renal function. This raises the possibility that blood pressure reduction by itself only partly explains their beneficial effect and beckons a broader understanding of vascular adaptation to diseases such as CKD. Determination of the pulse wave velocity (PWV) a reflection of large vessel stiffness has provided useful information in cardiovascular disease epidemiology. We hypothesize that pulse wave velocity predicts progression in subjects with chronic kidney disease, which we propose to test with three specific aims: Specific Aim 1: To determine pulse wave velocity in a heterogeneous cohort of subjects with chronic kidney disease. Specific Aim 2: To determine the utility of pulse wave velocity to predict of renal failure progression in a CKD cohort. Specific Aim 3: To determine the utility of pulse wave velocity to predict cardiovascular outcomes in a CKD cohort. These aims will be carried out in a population of 3000 individuals, 50% with diabetes, recruited at 7 clinical centers in the USA recruited over 30 months beginning in 2003. All data derived from this study will be managed here at Penn in cooperation with the Center for Biostatistics and Epidemiology. The techniques employed involve no risk to subjects and a minimal burden of time to perform. This revised application presents data on technique reproducibility, expanded preliminary data, tile incorporation of central augmentation index measures, and revised analysis & power sections that address tile many important issues raised by the critiques from tile first review. Improved recognition of etiological factors in CKD progression and cardiovascular endpoint occurrence will permit development and testing of interventions to reduce the burden of advanced renal failure and cardiovascular morbidity and mortality.

国家糖尿病、消化和肾脏疾病研究所（NIDDK）建立了慢性肾脏病研究所。 2001年的营养不足队列研究。审评委研究的主要目标是审查慢性疾病的风险因素， 肾病（CKD）进展（即肾功能进一步丧失）和心血管事件 不同严重程度的CKD，并开发预测模型，以识别CKD的高风险亚组。后者 结果将针对高风险受试者纳入未来的治疗试验， 预防性治疗。高血压治疗是改变肾性高血压病程的最有效的干预措施。 CKD的功能丧失。然而，用于治疗高血压的药物在肾功能方面的益处不同， 功能这就提出了一种可能性，即血压降低本身只能部分解释它们的有益作用。 并呼吁人们更广泛地了解血管对慢性肾病等疾病的适应性。脉搏波的测定 血流速度（PWV）反映了大血管的硬度，为心血管疾病提供了有用的信息 流行病学 我们假设脉搏波速度预测慢性肾脏疾病患者的进展， 建议测试三个具体目标： 具体目标1：确定慢性肾脏疾病受试者异质队列中的脉搏波速度。 具体目标2：确定脉搏波传导速度在CKD队列中预测肾衰竭进展的效用。 具体目标3：确定脉搏波速度预测CKD队列心血管结局的效用。 这些目标将在3000人的人群中进行，其中50%患有糖尿病，在7个临床中心招募， 从2003年开始，美国招募了30个月。本研究的所有数据将在宾夕法尼亚大学进行管理， 与生物统计学和流行病学中心合作。所采用的技术对受试者没有风险 和最小的时间负担来执行。本修订申请提供了技术再现性数据， 扩大的初步数据，纳入中央增强指数措施，并修订分析和 权力部分，解决瓷砖许多重要问题提出的批评，从瓷砖第一次审查。改进 对CKD进展和心血管终点发生的病因学因素的认识将允许开发 并测试干预措施，以减少晚期肾衰竭和心血管疾病发病率和死亡率的负担。