Hispanic Chronic Renal Insufficiency Cohort(CRIC) Study

描述(由申请者提供)：拉美裔美国人现在是美国最大的少数群体。与此同时，患有终末期肾病(ESRD)的西班牙裔患者的数量也大幅增加，1996至2005年间相对增加了63%。西班牙裔ESRD人口将继续大幅增长，因为拉美裔人口的总体规模不断扩大，糖尿病的高患病率，以及西班牙裔ESRD发病率的增加。尽管这个问题很严重，但对西班牙裔人群中肾脏疾病的早期阶段知之甚少。西班牙裔慢性肾功能不全队列(HCRIC)研究是多中心NIDDK赞助的慢性肾功能不全队列(CRIC)研究的辅助研究。HCRIC研究在09/2008年度成功地招募了327名患有慢性肾脏病(CKD)的拉美裔患者，这是第一项前瞻性的纵向研究，考察了相当大范围肾功能障碍的美国拉美裔人群中慢性肾脏病和心血管疾病进展的风险因素。这项工作正在通过目前的HCRIC奖(PI-Lash，5 R01 DK072231)的支持而进行，但不足以将科学调查的广度扩大到患有CKD的西班牙裔个人的关键健康决定因素。通过充分利用在上一个赠款周期中非常成功地招募和广泛收集关于HCRIC研究参与者的数据，这次竞争性续签提供了一个独特的机会，可以在经历不成比例的肾脏疾病负担的西班牙裔人口中调查关于慢性肾脏病健康后果的中心假设。这项相互竞争的更新主要针对三个具体目标，重点是对患有CKD的西班牙裔患者的虚弱、夜间血压和睡眠障碍的测量。此外，这项申请寻求将数据收集和后续行动再延长五年，以完成关键的纵向分析。我们认为，HCRIC研究的更新及其与整个CRIC研究的继续密切联系，为更充分地探索CKD和拉美裔心血管疾病进展的危险因素和机制提供了前所未有的机会。 公共卫生相关性：尽管在美国，发生肾衰竭需要透析的拉美裔人数正在急剧增加，但人们对拉美裔肾脏疾病的早期阶段知之甚少。西班牙裔慢性肾功能不全队列研究(HCRIC)是第一项对患有肾脏疾病的拉美裔美国人进行的长期研究，招募了327名患有肾脏疾病的拉美裔美国人，目的是增加我们对导致肾脏疾病及其相关心脏病恶化的因素的了解。HCRIC研究的更新将使我们能够探索患有肾脏疾病的拉美裔美国人的其他重要健康领域，提高我们对这一日益增长且鲜为人知的公共卫生问题的了解，并可能导致开发更有效的方法来预防和治疗拉美裔肾脏疾病。

DESCRIPTION (provided by applicant): Hispanics are now the nation's largest minority group. Concurrently, there has also been a dramatic increase in the number of Hispanic patients with end stage renal disease (ESRD), with a relative increase of 63% between 1996 and 2005. The Hispanic ESRD population will continue to undergo dramatic growth because of the increasing size of the overall Hispanic population, the high prevalence of diabetes mellitus, and the increased incidence of ESRD among Hispanics. Despite the magnitude of this problem, little is known regarding earlier stages of kidney disease in the Hispanic population. The Hispanic Chronic Renal Insufficiency Cohort (HCRIC) Study is an ancillary study to the multi-center NIDDK-sponsored Chronic Renal Insufficiency Cohort (CRIC) Study. The HCRIC Study successfully completed recruitment of 327 Hispanics with chronic kidney disease (CKD) in 09/2008 and is the first prospective longitudinal study examining risk factors for the progression of CKD and cardiovascular disease in a sizable cohort of U.S. Hispanics with a broad range of kidney dysfunction. This work is ongoing through support from the current HCRIC award (PI- Lash, 5 R01 DK072231) but is insufficient to expand the breadth of scientific inquiry to critical determinants of health among Hispanic individuals with CKD. By fully leveraging the highly successful recruitment of and extensive data collection on HCRIC study participants over the previous grant cycle, this competing renewal provides a unique opportunity to investigate central hypotheses regarding the health consequences of CKD among Hispanic populations that experience a disproportionate burden of kidney disease. This competing renewal principally addresses three Specific Aims, focusing on measures of frailty, nocturnal blood pressure, and sleep disturbances among Hispanics with CKD. In addition, this application seeks to extend data collection and follow-up for an additional five years in order to accomplish key longitudinal analyses. We believe that the renewal of the HCRIC Study and its continued close linkage to the overall CRIC Study provide an unprecedented opportunity to more fully explore both risk factors and mechanisms for CKD and cardiovascular disease progression among Hispanics. PUBLIC HEALTH RELEVANCE: Though the number of Hispanics in the U.S. developing kidney failure requiring dialysis is growing dramatically, very little is know about early stages of kidney disease in Hispanics. The Hispanic Chronic Renal Insufficiency Cohort (HCRIC) Study, the first long-term study of Hispanics with kidney disease, has enrolled 327 Hispanics with kidney disease with the goal of increasing our understanding of the factors responsible for worsening of kidney disease and its associated heart disease. A renewal of the HCRIC Study will allow us to explore additional important areas of health in Hispanics with kidney disease, improve our understanding of this growing and poorly understood public health problem, and potentially lead to the development of more effective ways to prevent and treat kidney disease in Hispanics.