Chronic Kidney Disease Prognosis Consortium (CKD-PC)

项目摘要/摘要 该提案详细介绍了慢性肾脏疾病预后联盟第三周期(2023-2028)的工作 (CKD-PC)。作为一个全球公共卫生问题，慢性肾脏病影响着世界10%的人口，也是导致 死亡。CKD-PC-一个由大约300名调查人员组成的全球小组，代表&>100个队列和&>3000万个 来自40个国家的个人-在推动重大进展方面发挥了重要作用 CKD，确定临床试验的替代终点，并建立一系列风险工具 在临床护理中的使用(ck dpc.org)。CKD-PC使用高效、流动的联合体结构、集中式分析、 和创新的荟萃分析方法，以推进CKD预后的流行病学研究 严谨程度、工作效率和临床影响。在这个阶段，我们的目标是为肾脏疾病的指南提供信息 慢性肾脏病流行和进展的证据；阐明慢性肾脏病在心力衰竭风险中的作用， 心律失常、感染、癌症、虚弱和痴呆；评估肾脏和CKD相关的表现 不同临床环境下的风险工具。目前的挑战包括：量化2021年《京都议定书》的影响-- 世界范围内的EPI方程；确定何时以及多久测试一次胱抑素C；以及确定 需要对肾脏和慢性肾脏病相关结局的风险计算器进行局部调整的情况。 我们将继续努力增加地区代表性，增强普遍性，并纳入 额外的临床试验，以便将观察到的风险与真实数据相对应，以便为指南提供信息-建议 治疗的阈值。我们保持灵活和有效率地回应由 指南组织和监管机构，如美国食品和药物管理局，以及 与包括全球疾病负担组织在内的其他财团合作。我们的首要目标是改进 CKD患者或有CKD风险的患者的健康。

PROJECT SUMMARY/ABSTRACT This proposal details work for the third cycle (2023-2028) of the Chronic Kidney Disease Prognosis Consortium (CKD-PC). A global public health problem, CKD affects >10% of the world population and is a leading cause of death. The CKD-PC – a global group of ~300 investigators representing >100 cohorts with >30 million individuals from >40 countries – has played an important role in facilitating major advances in the staging of CKD, the identification of surrogate endpoint for clinical trials, and the establishment of a range of risk tools for use in clinical care (ckdpc.org). The CKD-PC uses an efficient, fluid consortium structure, centralized analytics, and innovative meta-analysis methods to advance epidemiologic research in CKD prognosis at the highest level of rigor, productivity, and clinical impact. In this phase, we aim to inform guidelines in kidney disease with evidence on CKD prevalence and progression; elucidate the role of CKD in the risk of heart failure, arrhythmias, infections, cancer, frailty, and dementia; and evaluate the performance of kidney and CKD-related risk tools in different clinical settings. Current challenges include: quantifying the implications of the 2021 CKD- EPI equations world-wide; determining when and how often cystatin C should be tested; and identifying situations in which local adaptations of risk calculators for kidney and CKD-related outcomes are warranted. We will work to continue to increase regional representation, enhancing generalizability, and to incorporate additional clinical trials in order to map observed risks to real-world data to inform guideline-recommended thresholds for treatment. We remain flexible and efficient in responding to high priority topics set forth by guideline organizations and regulatory bodies such as the US Food and Drug Administration, and for collaboration with other consortia, including the Global Burden of Disease. Our overarching aim is to improve the health of patients with or at risk for CKD.