Hispanic Chronic Renal Insufficiency Cohort (CRIC) Study

描述(由申请人提供)： 根据2002年美国人口普查，拉美裔美国人现在是美国最大的少数群体。西班牙裔终末期肾病(ESRD)的人口也出现了戏剧性的增长，1996年至2001年期间，接受透析的拉美裔人数增加了70%以上。鉴于拉美裔总人口规模的增加、糖尿病的高患病率以及西班牙裔ESRD发病率的增加，预计西班牙裔ESRD人口将进一步增长。尽管这个问题很严重，但人们对拉美裔慢性肾脏疾病(CKD)的早期阶段知之甚少。伊利诺伊大学芝加哥分校(UIC)是慢性肾功能不全队列(CRIC)研究的七个临床中心之一，CRIC研究是由NIH赞助的一项多中心研究，调查了3000名CKD参与者肾脏和心血管疾病(CVD)进展的危险因素。CRIC的研究队列中50%是白人，50%是黑人。这项申请寻求建立一个相当大的西班牙裔CKD队列，并将其纳入整个CRIC研究。本应用程序的总体目标是： 1.确定西班牙裔CKD患者肾脏疾病和亚临床心血管疾病进展的预测因素。 2.比较患有CKD的西班牙裔与非西班牙裔白人和黑人的肾脏疾病和亚临床心血管疾病的进展率。 3.提高西班牙裔CKD患者肾小球滤过率(GFR)预测方程的准确性。 为了实现这些目标，我们将招募和保留316名在UIC患有CKD的西班牙裔参与者，以每年访问相关的暴露(人口统计、病史、药物、饮食、认知功能和生活质量)以及亚临床心血管疾病和肾功能的测量。为了测试对拉美裔美国人特别重要的假设，这项提案将集中在与内脏肥胖、炎症和医疗保健差异相关的问题上。拟议的研究与审评委的研究相联系，为探索拉美裔慢性肾脏病和心血管疾病进展的风险因素和机制提供了前所未有的机会，从科学和公共卫生的角度来看，这些都是至关重要的问题。

DESCRIPTION (provided by applicant): According to the 2002 U.S. Census, Hispanics are now the nation's largest minority group. There has also been a dramatic rise in the Hispanic end stage renal disease (ESRD) population, with the number of Hispanics on dialysis increasing by more than 70 percent between 1996 and 2001. Further growth of the Hispanic ESRD population is expected in view of the increasing size of the overall Hispanic population, a high prevalence of diabetes, and an increased incidence of ESRD in Hispanics. Despite the magnitude of this problem, little is known about earlier stages of chronic kidney disease (CKD) in Hispanics. The University of Illinois at Chicago (UIC) is one of seven clinical centers for the Chronic Renal Insufficiency Cohort (CRIC) Study, which is an NIH-sponsored multi-centered study investigating risk factors for progression of kidney and cardiovascular disease (CVD) in 3,000 participants with CKD. The CRIC Study cohort is 50 percent White and 50 percent Black. This application seeks to establish a sizable cohort of Hispanics with CKD that will be integrated into the overall CRIC Study. The overall aims of this application are: 1. To determine predictors of progression of kidney disease and subclinical CVD in Hispanics with CKD. 2. To compare rates of progression of kidney disease and subclinical CVD in Hispanics with CKD with those seen in non-Hispanic Whites and Blacks. 3. To improve the accuracy of glomerular filtration rate (GFR) prediction equations in Hispanics with CKD. To achieve these aims, we will recruit and retain 316 Hispanic participants with CKD at UIC to undergo annual visits for relevant exposures (demographics, medical history, medications, diet, cognitive function, and quality of life) and measurements of subclinical CVD and renal function. To test hypotheses of particular importance to Hispanics, this proposal will focus on issues related to visceral adiposity, inflammation, and health care disparities. The linkage of the proposed study to the CRIC Study provides an unprecedented opportunity to explore risk factors and mechanisms for CKD and CVD progression in Hispanics, which are problems of critical importance from both scientific and public health perspectives.