American Indian Chronic Renal Insufficiency Cohort Study (AI-CRIC)

美洲印第安人慢性肾功能不全队列研究 (AI-CRIC)

• 批准号: 9975168
• 负责人: VALLABH O SHAH
• 金额: $ 68.05万
• 依托单位: UNIVERSITY OF NEW MEXICO HEALTH SCIS CTR
• 依托单位国家: 美国
• 财政年份: 2019
• 资助国家: 美国
• 起止时间: 2019-07-09 至 2024-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9975168
• 关键词: Address; Adult; Affect; African American; Ambulatory Monitoring; American; American Indians; Atrial Fibrillation; Attention; Biological Markers; Biological Specimen Banks; Biometry; Cardiovascular Diseases; Cardiovascular system; Caucasians; Chronic Disease; Chronic Kidney Failure; Chronic Kidney Insufficiency; Cohort Studies; Communities; Creatinine; Data; Data Collection; Diabetes Mellitus; Diabetic Nephropathy; Disease; Disease Progression; Duct (organ) structure; Economics; Environmental Pollutants; Environmental and Occupational Exposure; Epidemic; Ethnic group; Evaluation; Event; Exposure to; Future; Goals; Health; Health Technology; Healthy People 2020; Heart failure; High Prevalence; Hispanics; Home environment; Hyperglycemia; Hypertension; Individual; Inequality; Injury to Kidney; Intervention; Kidney; Kidney Diseases; Longitudinal Studies; Measurement; Miniaturization; Monitor; National Health and Nutrition Examination Survey; Natural History; Nephrology; Outcome; Participant; Pattern; Phase; Phenotype; Population; Prevalence; Preventive Intervention; Principal Investigator; Prospective cohort study; Protocols documentation; Public Health; Race; Renal function; Research; Research Design; Research Personnel; Resources; Risk Factors; Societies; Source; Standardization; Technology; Testing; United States; base; cardiovascular disorder risk; cohort; disadvantaged population; disorder subtype; disparity reduction; ethnic minority population; experience; glucose monitor; handheld equipment; health disparity; health equity; high risk population; improved; mHealth; mortality; novel; programs; racial and ethnic; renal damage; social; socioeconomic disadvantage

Program Director/Principal Investigator (Last, First, Middle): Shah, Vallabh O and Unruh Mark Despite experiencing high levels of kidney disease compared to other ethnic/racial groups in the United States, American Indians (AIs) continue to receive relatively little attention from researchers studying CKD. An example is the current CRIC study, where less than 1% of participants in this flagship study are AIs. Risk factors for diabetic kidney disease, the predominant form of CKD in this population, include the traditional risk factors of hyperglycemia, hypertension, and inheritance, but also other factors such as exposure to various persistent environmental pollutants. The distribution and determinants of CKD among AIs has been understudied, leaving many questions unanswered about the progression of CKD among AIs, as well as the prevalence of cardiovascular disease (CVD) in the setting of CKD among these populations. This is an urgent issue given the public health impact in AI communities and the relative lack of ongoing research. To address this burden of CKD in Native communities we have formed a consortium of investigators with extensive experience in conducting research of chronic diseases including diabetes, cardiovascular and kidney disease in AIs of Southwestern US. Our proposed CRIC ancillary cohort study of 500 AIs (AI-CRIC) will rapidly improve our understanding of both potential risk factors for CKD progression, as well as the scope of this disease among AIs. This proposal leverages the current CRIC study and incorporates the planned activities of the next phase of the study – “CRIC 2018” – by implementing contemporary CRIC protocols for kidney and cardiovascular measurement and outcomes. The overall goal of the proposed prospective cohort study is to precisely assess the extent to which there are higher rates of CKD/CVD progression in AIs than in other racial/ethnic groups based on standardized definitions used throughout CRIC and relate CKD to the levels of potential environmental and occupational exposures unique to AIs residing in the American Southwest. To better understand the natural history of CKD/CVD in this high-risk population, AI-CRIC will implement the CRIC 2018 protocol of ambulatory monitoring of kidney function and damage along with evaluations of CVD sub-phenotypes using mobile health technologies. We will address these overarching goals with the following specific aims: Specific Aim 1: Conduct a longitudinal study of a CKD cohort of southwest AIs to identify unique risk factors for CKD and CVD progression and compare CKD and CVD event rates and risk factors between AI and other populations represented in CRIC; Specific Aim 2: Conduct ambulatory monitoring of kidney function and damage, and evaluate its relationship with exposure data; Specific Aim 3: Conduct CVD sub-phenotyping using mobile health technologies and evaluate its relationship with exposures data. This proposal takes advantage of the ongoing data collection and expertise of the CRIC study to address a gap in our understanding of CKD progression among AI. Ultimately, AI-CRIC will rapidly inform our understanding of the burden of CKD and provide disparity-reducing interventions. Importantly, the AI-CRIC addresses both an overarching goal of Healthy People 2020 to increase equity and reduce disparities and a priority issue for the American Society of Nephrology. OMB No. 0925-0001/0002 (Rev. 01/18 Approved Through 03/31/2020) Page Continuation Format Page

项目总监/首席研究员（最后、第一、中间）：Shah、Vallabh O 和 Unruh Mark 尽管与美国其他族裔/种族群体相比，肾脏疾病发病率较高， 研究 CKD 的研究人员对美洲印第安人 (AI) 的关注相对较少。一个例子 是目前 CRIC 的研究，这项旗舰研究中只有不到 1% 的参与者是人工智能。危险因素 糖尿病肾病是该人群中 CKD 的主要形式，包括以下传统危险因素： 高血糖、高血压和遗传，还有其他因素，例如暴露于各种持续的环境中 环境污染物。 CKD 在 AI 中的分布和决定因素尚未得到充分研究，因此 关于 AI 中 CKD 的进展以及 CKD 患病率的许多问题尚未得到解答 这些人群中 CKD 背景下的心血管疾病 (CVD)。这是一个紧迫的问题，因为 人工智能社区对公共健康的影响以及相对缺乏正在进行的研究。 为了解决原住民社区中 CKD 的负担，我们成立了一个研究人员联盟 在糖尿病、心血管和肾脏等慢性疾病研究方面拥有丰富的经验 美国西南部人工智能的疾病。我们提出的针对 500 名 AI 的 CRIC 辅助队列研究 (AI-CRIC) 将迅速 提高我们对 CKD 进展的潜在危险因素以及该疾病范围的了解 人工智能之间。该提案利用了 CRIC 目前的研究成果，并纳入了下一个计划的活动 研究阶段——“CRIC 2018”——通过实施当代肾脏和心血管的 CRIC 协议 测量和结果。拟议的前瞻性队列研究的总体目标是精确评估 AI 中 CKD/CVD 进展率高于其他种族/族裔群体的程度 基于整个 CRIC 所使用的标准化定义，并将 CKD 与潜在环境水平联系起来 以及居住在美国西南部的人工智能所特有的职业暴露。为了更好地了解自然 针对这一高危人群的 CKD/CVD 病史，AI-CRIC 将实施 CRIC 2018 门诊方案 使用移动健康监测肾功能和损伤以及评估 CVD 亚表型 技术。我们将通过以下具体目标来实现这些总体目标： 具体目标 1：对西南 AI 的 CKD 队列进行纵向研究，以确定独特的风险因素 CKD 和 CVD 进展，并比较 AI 和其他疾病之间的 CKD 和 CVD 事件发生率和危险因素 审评委所代表的人群； 具体目标 2：对肾功能和损伤进行动态监测，并评估其与肾功能的关系 暴露数据； 具体目标 3：使用移动医疗技术进行 CVD 亚表型分析并评估其关系 与曝光数据。 该提案利用了 CRIC 研究的持续数据收集和专业知识来弥补差距 我们对 AI 中 CKD 进展的理解。最终，AI-CRIC 将迅速传达我们的理解 慢性肾病的负担并提供减少差异的干预措施。重要的是，AI-CRIC 解决了 “健康人民 2020”的总体目标是增加公平和减少差距，也是 美国肾脏病学会。 OMB 编号 0925-0001/0002（修订版 01/18 批准至 03/31/2020） 页面延续格式页面