Prospective Evaluation of Acute Kidney Injury (PEAK) Cohort

描述（由申请人提供）： 急性肾损伤（阿基）是指肾功能的突然、意外下降，需要透析的阿基与短期死亡的高风险相关。其临床和公共卫生的重要性，强调了最近的研究表明，随着时间的推移，发病率上升。以往关于阿基的研究主要集中在阿基住院期间的结局，对长期结局知之甚少，包括慢性肾脏疾病发展和加速、死亡和复发性阿基的风险。作为对RFA-DK- 07-009“急性肾损伤自然史的辅助研究”的回应，我们提议建立一个临床中心，作为急性肾损伤自然史联盟的一部分。我们将提供200例患有阿基的病例受试者和200例匹配的对照。我们的申请是NIDDK申办的正在北方加州Kaiser Permanente和UCSF进行的阿基临床研究的辅助研究（R 01 DK 67126）。我们的四个具体目标是：目标1：与适当匹配的对照组相比，连续确定急性肾损伤患者长达4年的肾功能轨迹。目标二：评估急性肾损伤患者与适当匹配的对照组之间长达4年的死亡、心血管事件和其他结局的风险。目标3：为急性肾损伤发作后将发生或恶化慢性肾病或其他显著长期发病率或死亡率的患者确定和/或验证生物标志物或其他风险评估工具。目标4：为新的中央储存库做出贡献，以保存数据和生物样本，与科学界共享，用于未来急性肾损伤的分析和/或生物标志物研究。该提案的特殊优势包括：具有急性和慢性肾脏疾病流行病学专业知识的经验丰富的研究团队、成功招募和保留参与者进入长期随访研究的良好历史，以及北方加州Kaiser Permanente的独特基础设施，该基础设施可提供急性肾损伤发作前肾功能轨迹的关键信息。

DESCRIPTION (provided by applicant): Acute kidney injury (AKI) refers to a sudden, unexpected decrease in kidney function, and dialysis-requiring AKI is associated with a high risk of short-term death. Its clinical and public health importance is underscored by recent studies showing a rising incidence over time. Previous studies AKI have primarily focused only on outcomes during the AKI hospitalization, with little known about long-term outcomes, including risk of development and acceleration of chronic kidney disease, death and recurrent AKI. In response to RFA-DK- 07-009 "Ancillary Studies in the Natural History of Acute Kidney Injury," we propose to establish a Clinical Center as part of the Acute Kidney Injury Natural History Consortium. We will contribute 200 case subjects who suffered AKI and 200 matched controls. Our application is an ancillary study to ongoing NIDDK-sponsored clinical studies of AKI at Kaiser Permanente of Northern California and UCSF (R01 DK67126). Our four Specific Aims are: Aim 1: To sequentially determine the trajectory of kidney function for up to 4 years among patients who suffer acute kidney injury compared with appropriately matched controls. Aim 2: To assess the risks of death, cardiovascular events and other outcomes for up to 4 years between patients who suffer acute kidney injury compared with appropriately matched controls. Aim 3: To identify and/or validate biomarkers or other risk assessment tools for patients who will develop or have worsening chronic kidney disease, or other significant long-term morbidity or mortality after an episode of acute kidney injury. Aim 4: To contribute to a new central repository to preserve the data and biological samples to share with the scientific community for future analyses and/or biomarker studies in acute kidney injury. The particular strengths of this proposal include a very experienced research team with expertise in acute and chronic kidney disease epidemiology, a strong history of successful participant recruitment and retention into long-term follow-up studies, and a unique infrastructure at Kaiser Permanente of Northern California which provide critical information about kidney function trajectory before an episode of acute kidney injury.