Cohort Study of Chronic Renal Insufficiency

终末期肾病的发病率、发病率、死亡率和医疗费用 每年都在继续上升。此外，患心血管疾病(CVD)的风险约为 慢性肾功能不全(CRI)患者与普通人群相比更高。这个项目 建议跟踪3000名CRI患者的队列，以确定与肾功能下降相关的因素 心血管疾病的功能及发展进展。这将为制定减少 CRI和CVD在这一高危人群中的进展。 该中心组建了一支由经验丰富的调查人员组成的多学科团队，并记录了 在招募和留住长期心血管和肾脏试验参与者方面的专业知识。另一个 我们中心的优势是不同的医疗保健系统之间的协作方法，包括 这一领域的绝大多数医疗保健市场(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俄亥俄大学医院 克利夫兰)。已经确定，这些机构中有超过14,000名患者有记录在案 使他们有资格参与这项研究的血清肌酐水平。患者身份识别和 招聘将符合目前关于保密的指导方针。基线评估将 包括评估肾功能，以及常见的临床和亚临床心血管疾病。相关患者， 可能导致肾脏进展的环境和获得医疗保健的相关因素 不足之处将被衡量。传统的心血管危险因素，以及与 潜在的疾病和肾功能障碍也将得到评估。中央动脉的连续测量 依从性将在部分患者中进行。患者将接受年度检查和 每六个月进行一次电话采访。肾脏和心血管疾病的临床相关结果是 建议。我们经验丰富的研究人员将在留住参与者和确定 关于结果的。

The incidence of End Stage Renal Disease, with its attendant morbidity, mortality and health 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 identificationand 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.