Effects of Age and Race on GFR Estimation in a Population-based Cohort

基于人群的队列中年龄和种族对 GFR 估计的影响

• 批准号: 8540412
• 负责人: ANDREW S LEVEY
• 金额: $ 24.34万
• 依托单位: TUFTS MEDICAL CENTER
• 依托单位国家: 美国
• 财政年份: 2011
• 资助国家: 美国
• 起止时间: 2011-09-20 至 2016-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8540412
• 关键词: Address; Adult; Affect; Age; Age-Years; Asians; Atherosclerosis; Biological Markers; Black race; Blood specimen; Cardiovascular Diseases; Cessation of life; Chronic Kidney Failure; Clinical; Clinical Research; Creatinine; Cross-Sectional Studies; Detection; Development; Disease Progression; End stage renal failure; Enrollment; Equation; Ethnic Origin; Ethnic group; Event; Filtration; Funding; Future; General Population; Glomerular Filtration Rate; Goals; Gold; Health; Heart failure; Hispanics; Individual; Iohexol; Kidney; Kidney Diseases; Longevity; Measurement; Measures; Minority Groups; Neighborhoods; Participant; Persons; Plasma; Population; Prevalence; Protocols documentation; Public Health; Race; Relative (related person); Renal function; Research; Risk; Risk Factors; Sampling; Serum; Severities; Subgroup; United States; United States National Institutes of Health; Woman; adverse outcome; age effect; age related; base; clinical practice; cohort; disorder risk; follow-up; healthy aging; high risk; improved; innovation; longitudinal analysis; men; mortality; population based; post gamma-globulins; public health research; racial and ethnic; racial/ethnic difference; sex; standard measure

This protocol will evaluate the utility of the two GFR markers, creatinine and cystatin C, in comparison with measured glomerular filtration rate (GFR) by iohexol clearance in 375 Black and White adult participants of the population-based Multi-ethnic Study of Atherosclerosis (MESA) cohort from the Johns Hopkins clinical center. Although GFR estimation by creatinine has improved over the past decade, there has been inadequate inclusion of persons over 65 years of age, and no study of GFR measurement has occurred within a population-based sample of Blacks and Whites in the United States. To advance the detection and definition of CKD across a broad age range of diverse adults,, we must focus on the higher ranges of GFR, and we must identify the optimal strategy for GFR estimation. The first Aim of this cross-sectional study will be to determine the influence of Black race-ethnicity on serum levels of filtration markers (creatinine and cystatin C) in the general population, and to modify current GFR equations to capture optimally the influence of Black race. The second Aim will be: to evaluate age-related decline in GFR; to compare the relative ability of the filtration markers to capture declining GFR with age; and, to modify current GFR equations to incorporate the influence of age. In executing these Aims, we will determine the optimal biomarker(s) for GFR estimation ¿ creatinine, cystatin C, or both. In addition, blood specimens will be stored with the potential for examination of future filtration markers. To accomplish our objectives, we will measure iohexol-GFR in approximately 375 Black and White MESA participants, spanning a target age range of 55-95. This study could be a major contributor to the National Institute of Health¿s efforts to address the persistent racial disparities in the burden of kidney disease in the United States.

该方案将评估两种GFR标记肌酐和胱抑素C的实用性，与在375个基于人群的动脉粥样硬化（MESA）基于人群的多种族多种族研究的黑人和白人参与者中，Iohexol Clearsy在375个黑人和白人参与者中进行了iohexol Clearance（MESA）同类的375名黑人和白人参与者的实用性。尽管在过去的十年中，肌酐的GFR估计有所改善，但包括65岁以上的人的纳入不足，并且在美国的基于人群的黑人和白人样本中没有研究GFR测量。为了推进在广泛的潜水员成年时代范围内CKD的检测和定义，我们必须专注于GFR的较高范围，我们必须确定GFR估计的最佳策略。这项横断面研究的第一个目的是确定黑人种族种族对普通人群中过滤标记（肌酐和半胱氨酸蛋白酶）血清水平的影响，并修改当前的GFR方程，以最佳地捕获黑种族的影响。第二个目标是：评估与年龄有关的GFR下降；比较过滤标记物随着年龄的增长而捕获下降的相对能力；并且，要修改当前的GFR方程以结合年龄的影响。在执行这些目标时，我们将确定GFR估计的最佳生物标志物»肌酐，胱抑素C或两者兼而有之。此外，血液标本将储存，以检查未来过滤标记的潜力。为了实现我们的目标，我们将在大约375个黑白台面参与者中测量Iohexol-GFR，跨越55-95的目标年龄范围。这项研究可能是美国国立卫生研究所（National Shealth Institute of National Shealth）努力解决美国肾脏疾病伯恩（Burnen of Newd）肾脏持续种族分布的主要贡献者。