Proposal for a Chicago-CRIC Clinical Center

慢性肾功能不全(CRI)患者在我们人口中占很大比例，而且还在不断增长， 最近的增长很大程度上是由糖尿病发病率的增加推动的。心血管疾病的不良影响 终末期肾病(ESRD)人群中的疾病(CVD)有更早的开始，在 CRI，但相关的风险因素尚未完全确定。几种心血管疾病之间的重叠 肾脏疾病风险因素提示CRI和CVD之间的相互作用尚不完全清楚。这个 慢性肾功能不全前瞻性队列研究(CRIC)的主要目标是确定风险 肾功能加速下降的因素，并确定发病率，并确定危险因素， CRI人群中的心血管疾病。拟议中的芝加哥-CRIC财团是一个紧密联系的团体 具有以前合作历史的机构，为地理位置紧凑且人口稠密的 该地区为数百万成年患者提供服务，其中估计有9.6万人患有CRI和GFRS 在30-70ml/min/1.73m2的范围内。使用我们之前有效的策略为NIH招聘- 赞助的非裔美国人肾脏疾病和高血压研究(AASK)和备忘录试验，我们将招募 并保留芝加哥-CRIC服务的500名慢性肾功能不全(CRI)患者 机构。芝加哥-CRIC临床中心将提供为期六到七年的年度全面访问， 这将包括125-硫代氨基甲酸盐GFRs，血压测量，人体测量，尿液和血液测试， 心血管成像(电子束断层扫描[EBT]、超声心动图和颈动脉超声)。在……里面 此外，我们将提供定期的发病率和死亡率跟踪，其中将包括跟踪和 肾和心血管终点的分类。芝加哥-CRIC临床中心的优势在于 成员机构之间建立了合作的历史，我们作为调查人员在两年中的经验 先前涉及肾脏患者的大型NIH多中心临床研究(AASK和HEMO)，利用 现有的、由NIH资助的普通临床研究中心(GCRC)，用于所有研究访问，以及我们访问 包含非常大的CRI群体的数据库。

Individuals with chronic renal insufficiency (CRI) represent a large and growing segment of our population, with much of the recent growth fueled by the increased incidence of diabetes. The adverse impact of cardiovascular disease (CVD) in the end stage renal disease (ESRD) population has its beginnings earlier, during the course of CRI, but associated risk factors have not been completely characterized. The overlap between several CVD and renal disease risk factors suggests interactions between CRI and CVD that are not completely understood. The primary goals of the Prospective Cohort Study of Chronic Renal Insufficiency (CRIC) are to determine the risk factors for accelerated decline in renal function and to determine the incidence of, and identify risk factorsfor, cardiovascular disease in the CRI population. The proposed Chicago-CRIC Consortium is a group of closely tied institutions with a history of previous collaborations, serving a geographically compact and densely populated area, serving an adult patient population of several million among which an estimated 96,000 have CRI with GFRs in the range of 30-70 ml/min/1.73m2. Using our previously effective strategies in recruiting for theNIH- sponsored African American Study of Kidney Disease and Hypertension (AASK) and MEMO trials, we will recruit and retain 500 men and women with chronic renal insufficiency (CRI) from patients served by Chicago-CRIC institutions. The Chicago-CRIC Clinical Center will provide yearly Comprehensive Visits for six to seven years, which will include 125-iothalamate GFRs, blood pressure measurements, anthropometries, urine and blood testing, and cardiovascular imaging (electron beam tomograpy [EBT], echocardiography, and carotid ultrasound). In addition, we will provide regular morbidity and mortality follow-up, which will include the tracking and classification of renal and cardiovascular endpoints. The strengths of the Chicago-CRIC Clinical Center are the established history of collaboration between the member institutions, our experience as investigators in two previous large NIH multicenter clinical studies involving renal patients (AASK and HEMO), the utilization of an existing, NIH-funded General Clinical Research Center (GCRC) for all study visits, and our ability to access databases containing a very large CRI population.