LONGITUDINAL CHRONIC KIDNEY DISEASE STUDY

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This subproject is one of many research subprojects utilizing the resources provided by a Center grant funded by NIH/NCRR. The subproject and investigator (PI) may have received primary funding from another NIH source, and thus could be represented in other CRISP entries. The institution listed is for the Center, which is not necessarily the institution for the investigator. The world is facing an epidemic of chronic kidney disease (CKD). There is a relative paucity of data on the natural history and progression of this disease prior to the commencement of dialysis or transplantation (End Stage Renal Disease or ESRD). A multi-center registry of this disease has been in existence at the University of Michigan (UM) and four other academic centers since 2000 to study its epidemiology with emphasis on cardiovascular disease in these patients, renal disease progression and quality of life (QOL). A total of 602 patients have so far been recruited in this cohort study. Detailed medical data and QOL information have been collected on these patients by research coordinators at each site. Follow-up information is available on a subset of patients. Preliminary reports have been generated on QOL. Based on a critical review of the literature, it is postulated that these patients have a large burden of cardiovascular disease (CVD). Furthermore, the progression of CVD in CKD is likely to be substantial and there may be a parallelism with the rate of progression of the underlying kidney disease. It is proposed that as many patients as possible from the original cohort will be invited to the General Clinical Research Center (GCRC) at the UM and at other study centers for 2 visits at least 12 months apart. The second visit would be earlier if the CKD is rapidly progressive and patient is likely to reach ESRD sooner than 12 months. Objective measurements of CVD burden will be made at both visits by using select non-invasive cardiac tests (cardiac echocardiogram, measurement of stiffness or compliance of arteries, heart rate variability, coronary calcium deposit estimate by high resolution CAT scanning, and flow mediated vasodilatation which measures the ability of an artery to dilate in response to a blood pressure cuff occlusion for a few minutes). In addition, a sample of blood and urine will be obtained at each visit for assaying certain novel as well as traditional biomarkers whenever funding becomes available for the same. This study will yield a large body of extremely valuable data about CKD progression and cardiovascular disease progression in CKD and will form the basis for future clinical trials that are urgently needed to stem the current epidemic of CKD.