LONGITUDINAL CHRONIC KIDNEY DISEASE STUDY

这个子项目是利用由NIH/NCRR资助的中心拨款提供的资源的许多研究子项目之一。子项目和调查员(PI)可能从另一个NIH来源获得了主要资金，因此可能会出现在其他CRISE条目中。列出的机构是针对中心的，而不一定是针对调查员的机构。世界正面临着慢性肾脏疾病(CKD)的流行。在开始透析或移植(终末期肾病或终末期肾病)之前，关于这种疾病的自然病史和进展的数据相对较少。自2000年以来，密歇根大学(UM)和其他四个学术中心一直存在这种疾病的多中心登记，以研究其流行病学，重点是这些患者的心血管疾病、肾脏疾病进展和生活质量(QOL)。到目前为止，共有602名患者参加了这项队列研究。每个地点的研究协调员都收集了这些患者的详细医疗数据和生活质量信息。后续信息可用于部分患者。已经生成了关于生活质量的初步报告。基于对文献的严格回顾，推测这些患者有很大的心血管疾病(CVD)负担。此外，CKD中CVD的进展可能是实质性的，并且可能与潜在肾脏疾病的进展速度平行。建议尽可能多的患者从最初的队列中被邀请到密歇根大学的综合临床研究中心(GCRC)和其他研究中心进行至少12个月的2次访问。如果慢性肾脏病进展迅速，患者很可能在12个月内达到终末期肾病，那么第二次就诊的时间应该更早。在两次检查中都将通过选择非侵入性心脏测试(心脏超声心动图、测量动脉僵硬或顺应性、心率变异性、高分辨率CAT扫描估计冠状动脉钙沉积，以及血流介导的血管扩张测量动脉对血压袖带阻塞几分钟的反应能力)来测量心血管负荷。此外，每次就诊时都将采集血液和尿液样本，用于分析某些新的和传统的生物标记物，只要有资金可用。这项研究将产生大量关于CKD进展和心血管疾病进展的极有价值的数据，并将为未来迫切需要的临床试验奠定基础，以遏制当前的CKD流行。

This subproject is one of many research subprojects utilizing the resources provided by a Center grant funded by NIH/NCRR. The subproject and investigator (PI) may have received primary funding from another NIH source, and thus could be represented in other CRISP entries. The institution listed is for the Center, which is not necessarily the institution for the investigator. The world is facing an epidemic of chronic kidney disease (CKD). There is a relative paucity of data on the natural history and progression of this disease prior to the commencement of dialysis or transplantation (End Stage Renal Disease or ESRD). A multi-center registry of this disease has been in existence at the University of Michigan (UM) and four other academic centers since 2000 to study its epidemiology with emphasis on cardiovascular disease in these patients, renal disease progression and quality of life (QOL). A total of 602 patients have so far been recruited in this cohort study. Detailed medical data and QOL information have been collected on these patients by research coordinators at each site. Follow-up information is available on a subset of patients. Preliminary reports have been generated on QOL. Based on a critical review of the literature, it is postulated that these patients have a large burden of cardiovascular disease (CVD). Furthermore, the progression of CVD in CKD is likely to be substantial and there may be a parallelism with the rate of progression of the underlying kidney disease. It is proposed that as many patients as possible from the original cohort will be invited to the General Clinical Research Center (GCRC) at the UM and at other study centers for 2 visits at least 12 months apart. The second visit would be earlier if the CKD is rapidly progressive and patient is likely to reach ESRD sooner than 12 months. Objective measurements of CVD burden will be made at both visits by using select non-invasive cardiac tests (cardiac echocardiogram, measurement of stiffness or compliance of arteries, heart rate variability, coronary calcium deposit estimate by high resolution CAT scanning, and flow mediated vasodilatation which measures the ability of an artery to dilate in response to a blood pressure cuff occlusion for a few minutes). In addition, a sample of blood and urine will be obtained at each visit for assaying certain novel as well as traditional biomarkers whenever funding becomes available for the same. This study will yield a large body of extremely valuable data about CKD progression and cardiovascular disease progression in CKD and will form the basis for future clinical trials that are urgently needed to stem the current epidemic of CKD.