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: 9814869
• 负责人: VALLABH O SHAH
• 金额: $ 69.62万
• 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/9814869
• 关键词: Address; Adult; Affect; African American; Ambulatory Monitoring; American; American Indians; Atrial Fibrillation; Attention; Biological Markers; 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; 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; Specimen; 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; socioeconomics

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

项目主任/首席调查员(最后、第一、中间)：Shah、Vallabh O和Unruh Mark 尽管与美国其他民族/种族相比，肾脏疾病的水平很高， 美国印第安人(AIS)仍然受到研究CKD的研究人员相对较少的关注。一个例子 是目前的CRIC研究，在这项旗舰研究中，只有不到1%的参与者是人工智能。风险因素 糖尿病肾病是该人群中CKD的主要形式，包括传统的 高血糖、高血压和遗传性等因素也会持续暴露于各种因素 环境污染物。CKD在认可机构中的分布和决定因素一直研究不足，留下了 有关认可机构慢性肾脏病的进展，以及 这些人群中与慢性肾脏病相关的心血管疾病(CVD)。这是一个紧迫的问题，因为 人工智能社区的公共健康影响以及相对缺乏正在进行的研究。 为了解决CKD在土著社区的负担，我们成立了一个由调查人员组成的联盟， 有从事糖尿病、心血管和肾脏等慢性疾病研究的丰富经验 美国西南部人工智能中的疾病。我们提议的对500个人工智能的CRIC辅助队列研究(AI-CRIC)将迅速 提高我们对慢性肾脏病进展的潜在危险因素以及疾病范围的了解。 在人工智能中。该提案利用了目前的审评委研究，并纳入了下一个审评委计划的活动 研究阶段--“CRIC 2018”--通过实施当代的CRIC肾脏和心血管系统议定书 测量和结果。拟议的前瞻性队列研究的总体目标是准确评估 AIS的CKD/CVD进展率比其他种族/民族高的程度 基于整个审评委使用的标准化定义，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机构独有的职业暴露。为了更好地理解自然界 CKD/CVD的病史在这一高危人群中，AI-CRIC将实施CRIC 2018门诊方案 使用移动健康监测肾功能和损害以及评估心血管疾病亚型 技术。我们将通过以下具体目标解决这些总体目标： 具体目标1：对西南部AIS的CKD队列进行纵向研究，以确定发生以下疾病的独特风险因素 CKD和CVD进展，比较人工智能和其他疾病的CKD和CVD事件发生率和危险因素 审评委代表的人口； 具体目标2：对肾功能和损害进行动态监测，并评估其与 曝光数据； 具体目标3：利用移动保健技术进行心血管疾病亚型分型并评估其关系 曝光数据。 这项提议利用审评委研究的持续数据收集和专门知识来弥补差距。 在我们对人工智能中CKD进展的理解中。最终，AI-CRIC将迅速告知我们对 减少慢性肾脏病的负担，并提供缩小差距的干预措施。重要的是，AI-CRIC既解决了 2020年健康人的总体目标是增加公平和减少差距，这是 美国肾脏病学会。 OMB编号0925-0001/0002(01/18修订版批准至2020年3月31日)页面续格式页面