AASK Cohort Study

描述(由申请人提供)： 高血压性肾病通常会进展。AASK(非裔美国人肾脏疾病和高血压研究)队列研究的主要目标是前瞻性地确定患有高血压肾病并接受推荐抗高血压治疗的非裔美国人的肾功能进程和肾脏疾病进展的危险因素。第二个目标是确定心血管疾病的发生并评估其危险因素。 AASK队列研究是一项前瞻性观察性研究，是AASK试验的延伸。AASK试验测试了作为初始降压治疗的3种药物(雷米普利、美托洛尔和氨氯地平)和2种血压控制水平对肾功能的影响。在1094名试验参与者中，大约650到700名尚未达到终末期肾病(ESRD)的人可能会参加队列研究。要研究的风险因素包括环境、遗传、生理和社会经济变量。原发肾脏结局是一种综合的临床结局，其定义为血肌酐增加一倍，终末期肾病或死亡。高血压的药物治疗，从血管紧张素转换酶抑制剂雷米普利开始，向所有参与者提供。通过这种方式，这项研究直接控制了肾脏疾病进展的两个主要决定因素(高血压的治疗和肾脏保护性抗高血压药物的使用)。队列研究的最短随访期为5年(总计9至12年，包括AASK试验期间)。在霍普金斯中心，我们计划招募54名参与者，44名参与者将是积极参与者，有资格进行所有方案测量，以及10名已达到终末期肾脏疾病的参与者，他们将同意进行DNA采样和随访。在队列研究期间实现完全的参与者登记和保留是霍普金斯临床中心的重要目标。 最终，来自AASK队列研究的数据应该会加强我们对决定肾脏疾病进展的风险因素和过程的理解。这样的结果可能最终导致延迟或预防ESRD的新战略。

DESCRIPTION (provided by applicant): Hypertensive kidney disease commonly progresses. The primary objective of the AASK (African American Study of Kidney Disease and Hypertension) Cohort Study is to determine prospectively the course of kidney function and risk factors for kidney disease progression in African-Americans with hypertensive kidney disease who receive recommended antihypertensive therapy. A secondary objective is to determine the occurrence of cardiovascular disease and assess its risk factors. The AASK Cohort Study is a prospective, observational study that is an extension of the AASK trial. The AASK trial tested the effects on kidney function of 3 medications used as initial antihypertensive therapy (ramipril, metoprolol and amlodipine) and 2 levels of blood pressure control. Of the 1,094 trial participants, approximately 650 to 700 individuals who have not reached end stage renal disease (ESRD) will likely enroll in the Cohort Study. Risk factors to be studied include environmental, genetic, physiologic, and socio-economic variables. The primary renal outcome is a composite clinical outcome defined by doubling of serum creatinine, ESRD, or death. Medication treatment for hypertension, beginning with the angiotensin converting enzyme inhibitor ramipril, is offered to all participants. In this fashion, the study directly controls two of the major determinants of kidney disease progression (treatment of hypertension and use of reno-protective, antihypertensive medication). The minimum duration of follow-up in the Cohort Study is 5 years (total of 9 to 12 years, including the period of the AASK trial). At the Hopkins Center, we plan to enroll 54 participants, 44 participants who will be active participants and eligible for all protocol measurements, and 10 participants who have reached end-stage renal disease who will consent for DNA sampling and follow-up. Achieving complete participant enrollment and retention during the cohort study are important goals of the Hopkins clinical center. Ultimately, data from the AASK Cohort Study should enhance our understanding of the risk factors and processes that determine the progression of kidney disease. Such results might eventually lead to new strategies that delay or prevent ESRD.