Mexican Chronic Renal Insufficiency Cohort Study

描述(由研究人员提供)：拟议的墨西哥慢性肾功能不全队列研究是由美国国立卫生研究院资助的研究人员James P.Lash医学博士和Magdalena Madero医学博士合作进行的，Magdalena Madero医学博士是墨西哥城Ignacio Chavez国家心脏病研究所的肾病学家。在墨西哥，慢性肾脏疾病(CKD)是一个日益严重的公共卫生问题，在过去10年中，发病率以每年11%的速度增长。此外，慢性肾脏病是墨西哥医院内死亡的第三大常见原因。尽管这个问题很严重，但人们对墨西哥慢性肾脏病的流行病学知之甚少。更好地了解慢性肾脏病进展的危险因素至关重要，因为在墨西哥，只有不到一半的肾衰竭患者可以进行透析或肾移植。这项申请的总体目标是招募和保留340人 患有轻中度慢性肾脏病的墨西哥人。在支持期间产生的初步数据将被用于申请外部资金，以延长参与者的随访，以实现以下长期特定目标：1)确定墨西哥CKD患者肾脏疾病进展的危险因素；2)确定心血管事件和亚临床心血管疾病进展的危险因素；3)评估CKD与其他临床结果(如功能状态、生活质量和抑郁)之间的关系；4)比较生活在墨西哥的墨西哥CKD患者和生活在美国的墨西哥CKD患者之间的CKD进展率。这项拟议的研究将利用NIDDK资助的一个积极研究项目的基础设施，该项目专注于调查美国拉美裔和非拉美裔CKD的流行病学(首席调查员Lash，R01 DK72231和U01 DK60980)和伊利诺伊大学芝加哥公共卫生学院提供的广泛培训资源。该应用程序通过在墨西哥建立流行病学CKD研究能力，并为Madero博士和她所在机构的其他受训者提供研究方法培训，实现了Fogarty国际研究协作奖计划的使命。此外，通过研究获得的知识有可能为未来旨在改善墨西哥CKD患者健康结局的干预性试验的设计提供参考。 公共卫生相关性：慢性肾脏疾病(CKD)在墨西哥是一个日益严重、研究不足的公共卫生问题，也是最常见的死亡原因之一。这项拟议的研究将招募340名患有CKD的墨西哥人，以实现四个长期目标：1)确定CKD患者肾脏疾病进展的危险因素；2)确定心血管疾病进展的危险因素；3)评估CKD与功能状态、生活质量和抑郁的关系；4)比较居住在墨西哥的CKD患者和生活在美国的墨西哥CKD患者之间的肾脏疾病进展速度。这项研究所获得的知识可能会指导未来的干预性研究的设计，目标是改善墨西哥CKD患者的健康结果。

DESCRIPTION (provided by investigator): The proposed Mexican Chronic Renal Insufficiency Cohort Study is collaboration between a U.S. based NIH- funded investigator, James P. Lash, MD and Magdalena Madero, MD, a nephrologist at the Instituto Nacional de Cardiologia Ignacio Chavez in Mexico City. In Mexico, chronic kidney disease (CKD) represents a growing public health problem, with an increase in prevalence of 11% per year in the last 10 years. Furthermore, CKD is the third most common cause of in-hospital mortality in Mexico. Despite the magnitude of this problem, little is known about the epidemiology of CKD in Mexico. A better understanding of risk factors for progression of CKD is of critical importance because less than one-half of patients with kidney failure in Mexico have access to dialysis or kidney transplantation. The overall objective of this application is to recruit and retain a cohort of 340 Mexicans with mild-to-moderate CKD. Preliminary data generated during the period of support will be utilized to apply for extramural funding to extend participant follow-up in order to accomplish the following long- term Specific Aims: 1) Identify risk factors for progression of kidney disease in Mexicans with CKD; 2) Identify risk factors for cardiovascular events and progression of subclinical cardiovascular disease; 3) Evaluate the association between CKD and other clinical outcomes such as functional status, quality of life, and depression; and 4) Compare rates of CKD progression between Mexicans with CKD living in Mexico and Mexicans with CKD living in the U.S. The proposed study will leverage the infrastructure of an active NIDDK-funded research program which is focused on investigating the epidemiology of CKD in U.S. Hispanics and non-Hispanics (Principal Investigator Lash, R01 DK72231, and U01 DK60980) and the extensive training resources available at the University of Illinois at Chicago School of Public Health. This application fulfills the mission of the Fogarty International Research Collaboration Award program by building epidemiologic CKD research capabilities in Mexico and providing training in research methodology for Dr. Madero and other trainees at her institution. Furthermore, the knowledge gained by the research has the potential to inform the design of future interventional trials with the goal of improving health outcomes for Mexicans with CKD. PUBLIC HEALTH RELEVANCE: Chronic kidney disease (CKD) is a growing, understudied public health problem in Mexico and is one of the most common causes of death. The proposed study will enroll 340 Mexicans with CKD in order to accomplish four long-term goals: 1) Identify risk factors for the progression of kidney disease in Mexicans with CKD; 2) Identify risk factors for the progression of cardiovascular disease; 3) Evaluate the relationship between CKD and functional status, quality of life, and depression; and 4) Compare rates of kidney disease progression between Mexicans with CKD living in Mexico and Mexicans with CKD living in the U.S. The knowledge gained by this research may potentially guide the design of future interventional studies with the goal of improving health outcomes for Mexicans with CKD.