Hispanic Chronic Renal Insufficiency Cohort(CRIC) Study

描述（由申请人提供）：西班牙裔现在是美国最大的少数民族。同时，患有终末期肾病（ESRD）的西班牙裔患者数量也急剧增加，1996年至2005年期间相对增加了63%。西班牙裔ESRD人口将继续急剧增长，因为西班牙裔总体人口规模的增加、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，但对西班牙裔人群早期肾脏疾病的了解却很少。西班牙慢性肾功能不全队列（HCRIC）研究是niddk赞助的多中心慢性肾功能不全队列（CRIC）研究的辅助研究。HCRIC研究于2008年9月成功招募了327名患有慢性肾脏疾病（CKD）的西班牙裔患者，这是第一个在具有广泛肾功能障碍的相当大的美国西班牙裔患者队列中检查CKD和心血管疾病进展危险因素的前瞻性纵向研究。这项工作正在通过当前HCRIC奖（PI- Lash, 5 R01 DK072231）的支持进行，但不足以扩大对西班牙裔CKD患者健康关键决定因素的科学探究的广度。在之前的资助周期中，通过充分利用HCRIC研究参与者的高度成功招募和广泛的数据收集，这一竞争性更新提供了一个独特的机会，可以研究关于慢性肾病在西班牙裔人群中健康后果的中心假设，这些西班牙裔人群承受着不成比例的肾脏疾病负担。这项竞争性更新主要针对三个特定目标，重点关注西班牙裔慢性肾病患者的虚弱、夜间血压和睡眠障碍的测量。此外，该应用程序力求将数据收集和随访时间延长5年，以便完成关键的纵向分析。我们认为，HCRIC研究的更新及其与整体CRIC研究的持续密切联系为更充分地探索西班牙裔CKD和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。

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.