Chronic Kidney Disease in Children (CKiD)

描述（由申请人提供）： 慢性肾脏病（CKD）及其代谢紊乱严重影响儿童的健康。为了确定进展性CKD不良反应的性质、程度和时间演变，我们建议在儿童中进行一项CKD前瞻性研究，以确定（1）肾功能加速下降的风险因素;（2）脑功能和结构受损的发生率、性质、程度和时间演变;（3）心血管疾病（CVD）风险因素的患病率;（4）生长障碍及其治疗对发病率的影响。儿童慢性肾脏病前瞻性研究（C-Kid）是一项纵向观察性研究，纳入了600名年龄< 19岁的轻度至中度肾功能受损（估计肾小球滤过率（GFR）30-75 ml/min/1.73 m2）的儿童。随访期为2.5 - 4.5年。在入组时以及此后的年度访视时，将使用标准化问卷获得受试者的选定暴露量，包括社会人口统计学特征、家族史、医疗保健利用、环境暴露和药物使用。还将测量标准化血压、生长和营养评估、代谢状态、贫血、血脂异常的测量、微炎症、胰岛素抵抗和蛋白尿的测量。每年通过碘海醇的血浆消失测量肾功能（GFR）水平。关注的主要结局将是亚临床指标和与CKD进展相关的临床事件的时间演变，如GFR下降、生长障碍及其治疗、神经认知和行为缺陷以及心血管疾病所测量，具体见我们的以下目标。可以使用C-Kid基础设施进行的潜在分析，以探索风险因素疾病关系，包括传统的前瞻性队列分析，其中在基线时测量参与者的假定风险因素;巢式病例对照研究，其中在病例中对储存的基线标本进行实验室研究。（例如，快速进展者）和适当匹配的对照（例如，非进展者）;以及利用平行组群的跨组群分析。

DESCRIPTION (provided by applicant): Chronic kidney disease (CKD) and its metabolic derangements substantially affect the well-being of children. In order to define the nature, magnitude, and temporal evolution of the adverse effects of progressive CKD, we propose to conduct a prospective study of CKD in children to determine (1) risk factors for accelerated decline in renal function; (2) incidence, nature, magnitude and temporal evolution of impaired brain function and structure; (3) prevalence of risk factors for cardiovascular disease (CVD); and (4) implications of growth failure and its treatment on morbidity. ]'he Prospective Study of Chronic Kidney Disease in Children (C-Kid) is a longitudinal, observational study of 600 children, aged < 19 yrs with mildly to moderately impaired kidney function (estimated glomerular filtration rate (GFR) 30-75 ml/min/1.73m2). The follow-up period will be 2.5 to 4.5 years. At enrollment, and at annual visits thereafter, selected exposures will be obtained on participants, including sociodemographic characteristics, family history, health care utilization, environmental exposures and medication use using standardized questionnaires. Standardized blood pressure, growth and nutritional assessments, metabolic status, measures of anemia, dyslipidemia, measures of microinflammation, insulin resistance and proteinuria will also be measured. Level of kidney function (GFR) will be measured annually by plasma disappearance of iohexol. The primary outcomes of interest will be the temporal evolution of subclinical measures and clinical events associated with CKD progression as measured by decline in GFR, growth failure and its treatment, neurocognitive and behavioral deficits and cardiovascular disease, specified in our aims below. Potential analyses that could be conducted using the C-Kid infrastructure to explore risk-factor disease relationships include traditional prospective cohort analyses where putative risk factors are measured in participants at baseline; nested case-control studies in which laboratory studies are performed on stored baseline specimens in cases (e.g. rapid progressors) and appropriately matched controls (e.g. non-progressors); and cross-cohort analyses utilizing parallel cohorts.