Chronic Kidney Disease Prognosis Consortium

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DESCRIPTION (provided by applicant): Chronic kidney disease (CKD) is a global public health epidemic, affecting 10-16% of the adult population in Asia, Europe, and North America. The clinical impact of CKD is substantial: risks of end stage renal disease (ESRD), cardiovascular disease (CVD), and premature mortality are all heightened. Despite substantial progress, there are several unanswered questions in the field of CKD epidemiology, in part due to the heterogeneity of analytic strategies, measurement of kidney disease markers, and outcome definitions used in published studies. A rigorous, uniform approach using extensive, globally collected data is needed to solidify the foundation of evidence for CKD management, research initiatives, and strategies for prevention. The CKD Prognosis Consortium (CKD-PC) was formed in 2009 using seed money from the National Kidney Foundation and now comprises ~200 investigators from 50 cohorts world-wide; new cohorts join each year. With estimated glomerular filtration rate (eGFR) and albuminuria measures in >2.5 million participants representing general, high cardiovascular risk, and CKD populations, the CKD-PC developed a track record of producing high impact papers. CKD-PC complements established CKD cohorts by representing a broad range of global populations, spanning the full range of kidney function, and meta-analyzing where appropriate data exist. Using a fluid structure with uniform, centralized analytics, CKD-PC will pursue three broad aims: Aim 1: To determine the relationship of CKD progression to risk of ESRD, mortality, and other outcomes. This will inform selection of surrogate outcomes for clinical trials and tracking of patients with respect to CKD progression. Aim 2: To develop risk prediction models for CKD-related outcomes (e.g., CVD and ESRD) across a range of patient populations. These risk scores will inform clinical decision making. Aim 3: To pursue additional high priority topics in close collaboration with consortium members. We are expanding the range of outcomes, risk factors, and methodologic research. The aims comprise 18 manuscript topics; we plan to publish at least four rigorous meta- analyses each year. At all steps, we will work to improve standardization of CKD measures and outcomes, develop rigorous and innovative statistical methods, and share analytical tools and techniques across cohorts and with the public. Previous work by the CKD-PC has already proved useful for clinical guidelines and FDA evaluation of CKD progression in clinical trials. This grant would fund sustained productivity addressing important questions.