Chronic Kidney Disease Prognosis Consortium

描述(申请人提供)：慢性肾脏病(CKD)是一种全球公共卫生流行病，影响亚洲、欧洲和北美10%-16%的成年人口。慢性肾脏病的临床影响是巨大的：终末期肾病(ESRD)、心血管疾病(CVD)和过早死亡的风险都会增加。尽管取得了实质性的进展，但在慢性肾脏病流行病学领域仍有几个悬而未决的问题，部分原因是已发表的研究中使用的分析策略、肾脏疾病标记物的测量和结果定义的异质性。需要一种使用广泛的全球收集的数据的严格、统一的方法，以巩固CKD管理、研究计划和预防战略的证据基础。CKD预后联盟(CKD-PC)成立于2009年，使用国家肾脏基金会的种子资金，目前由来自世界各地50个队列的约200名研究人员组成；每年都有新的队列加入。CKD-PC在250万名参与者中进行了肾小球滤过率(EGFR)和蛋白尿的测量，这些参与者代表了普通人群、心血管高危人群和CKD人群，CKD-PC开发了制作高影响力论文的记录。CKD-PC补充了已建立的CKD队列，代表了广泛的全球人群，跨越了整个肾功能范围，并在存在适当数据的情况下进行了荟萃分析。使用统一、集中分析的流体结构，CKD-PC将追求三个广泛的目标：目标1：确定CKD进展与终末期肾病风险、死亡率和其他结果的关系。这将为临床试验的替代结果的选择和关于CKD进展的患者跟踪提供信息。目的2：建立一系列患者人群中CKD相关结局(如CVD和ESRD)的风险预测模型。这些风险评分将为临床决策提供信息。目标3：与财团成员密切合作，寻求更多的高优先议题。我们正在扩大结果、风险因素和方法研究的范围。目标包括18个手稿主题；我们计划每年至少发表四篇严格的荟萃分析。我们将在所有步骤上提高CKD测量和结果的标准化，发展严谨和创新的统计方法，并在队列和公众之间共享分析工具和技术。CKD-PC之前的工作已经被证明对临床指南和FDA在临床试验中对CKD进展的评估有用。这笔拨款将为解决重要问题的持续生产力提供资金。

DESCRIPTION (provided by applicant): Chronic kidney disease (CKD) is a global public health epidemic, affecting 10-16% of the adult population in Asia, Europe, and North America. The clinical impact of CKD is substantial: risks of end stage renal disease (ESRD), cardiovascular disease (CVD), and premature mortality are all heightened. Despite substantial progress, there are several unanswered questions in the field of CKD epidemiology, in part due to the heterogeneity of analytic strategies, measurement of kidney disease markers, and outcome definitions used in published studies. A rigorous, uniform approach using extensive, globally collected data is needed to solidify the foundation of evidence for CKD management, research initiatives, and strategies for prevention. The CKD Prognosis Consortium (CKD-PC) was formed in 2009 using seed money from the National Kidney Foundation and now comprises ~200 investigators from 50 cohorts world-wide; new cohorts join each year. With estimated glomerular filtration rate (eGFR) and albuminuria measures in >2.5 million participants representing general, high cardiovascular risk, and CKD populations, the CKD-PC developed a track record of producing high impact papers. CKD-PC complements established CKD cohorts by representing a broad range of global populations, spanning the full range of kidney function, and meta-analyzing where appropriate data exist. Using a fluid structure with uniform, centralized analytics, CKD-PC will pursue three broad aims: Aim 1: To determine the relationship of CKD progression to risk of ESRD, mortality, and other outcomes. This will inform selection of surrogate outcomes for clinical trials and tracking of patients with respect to CKD progression. Aim 2: To develop risk prediction models for CKD-related outcomes (e.g., CVD and ESRD) across a range of patient populations. These risk scores will inform clinical decision making. Aim 3: To pursue additional high priority topics in close collaboration with consortium members. We are expanding the range of outcomes, risk factors, and methodologic research. The aims comprise 18 manuscript topics; we plan to publish at least four rigorous meta- analyses each year. At all steps, we will work to improve standardization of CKD measures and outcomes, develop rigorous and innovative statistical methods, and share analytical tools and techniques across cohorts and with the public. Previous work by the CKD-PC has already proved useful for clinical guidelines and FDA evaluation of CKD progression in clinical trials. This grant would fund sustained productivity addressing important questions.