Continuation of the Chronic Renal Insufficiency Cohort (CRIC) Study

描述（由申请人提供）：这是宾夕法尼亚大学临床流行病学和生物统计学中心申请作为慢性肾功能不全队列（CRIC）研究继续的科学和数据协调中心（SDCC）。 慢性肾功能不全（CRI）影响着超过2000万美国人，其中老年人的负担特别重。 与慢性肾脏疾病（CKD）相关的发病率来自于频繁进展为终末期肾脏疾病（ESRD）、心血管事件的不成比例风险以及与残疾和高护理成本相关的其他发病率。 一组病因学因素被确定为可能导致CKD背景下的进行性肾脏疾病和发病率，特别是那些在CKD病程早期可能阻止进展的因素。 这些因素包括临床、行为和与生物标志物相关的因素。 描述这些风险因素和结果之间的关系将允许开发工具来预测CRI患者的不良结果，并增强对导致这些结果的病因机制的理解。 改善预测将允许识别具有CRI的高风险亚组，从而指导预防性治疗试验的招募和预防性治疗的应用。 拟议的审评委第三阶段将联合收割机结合对审评委这些现有参与者的研究，沿着另外1，500名参与者，以实现理解肾脏疾病与心血管和其他类型发病率风险之间关系的总体目标。 特别是，在第三阶段，审评委的SDCC将继续为审评委研究网络提供科学、数据分析和后勤支持，因为它将继续解决一系列不同的高影响力研究领域，重点扩大到老年人CKD、中度CKD患者以及CKD患者的发病率负担。CRIC研究队列是一个无与伦比的资源，也将通过在整个肾脏研究界的额外合作以及与全球其他流行病学研究的互动，扩大我们开展CKD相关科学研究的能力。

DESCRIPTION (provided by applicant): This is an application from the Center for Clinical Epidemiology and Biostatistics at the University of Pennsylvania to serve as the Scientific and Data Coordinating Center (SDCC) for the Continuation of the Chronic Renal Insufficiency Cohort (CRIC) Study. Chronic renal insufficiency (CRI) affects over 20 million Americans with particular burden among older adults. The morbidity associated with chronic kidney disease (CKD) derives from frequent progression to end-stage renal disease (ESRD), a disproportionate risk of cardiovascular events, and other morbidities associated with disability and high costs of care. A set of etiological factors is being identified as potentially responsible for both progressive renal disease and morbidities in the setting of CKD, especially those operating early in the course of CKD when progression may be forestalled. These factors include clinical, behavioral, and those associated with biomarkers. Characterizing relationships between these risk factors and outcomes will permit development of instruments to predict poor outcomes in patients with CRI and enhance understanding of the etiological mechanisms leading to these outcomes. Improved prediction will allow identification of high-risk subgroups with CRI, thus guiding enrollment into preventive treatment trials and application of preventive therapies. The proposed third phase of CRIC will combine the study of these current CRIC participants along with 1,500 additional study participants to address overarching goals of understanding the relationship between kidney disease and the risks of cardiovascular and other types of morbidity. In particular, during Phase III, CRIC's SDCC will continue to provide scientific, data analytical, and logistical support to the CRIC Research Network as it continues to address a diverse set of high-impact areas of investigation with expanded emphasis on CKD in older adults, patients with moderate levels of CKD, and the burden of morbidity in patients with CKD. The CRIC Study cohort is an unparalleled resource that will also expand our ability to conduct science related to CKD through additional collaborations throughout the renal research community and interactions with other epidemiologic studies worldwide.