Continuation of the Chronic Renal Insufficiency Cohort (CRIC) Study

描述(由申请人提供)：这是宾夕法尼亚大学临床流行病学和生物统计中心提出的申请，作为慢性肾功能不全队列(CRIC)研究的继续研究的科学和数据协调中心(SDCC)。慢性肾功能不全(CRI)影响着2000多万美国人，老年人的负担尤其沉重。与慢性肾脏疾病(CKD)相关的发病率源于频繁进展为终末期肾脏疾病(ESRD)、心血管事件的不成比例风险以及与残疾和高昂的护理费用相关的其他疾病。在慢性肾脏病的背景下，一组病因被认为是进行性肾脏疾病和发病率的潜在原因，特别是那些在慢性肾脏病病程早期操作的因素，当进展可以被预防的时候。这些因素包括临床、行为和与生物标记物相关的因素。确定这些危险因素和预后之间的关系将有助于开发预测CRI患者不良预后的工具，并加强对导致这些预后的病因机制的理解。改进的预测将允许识别患有CRI的高危亚组，从而指导登记参加预防性治疗试验和预防性治疗的应用。拟议的CRIC第三阶段将结合对这些现有CRIC参与者以及另外1500名研究参与者的研究，以解决了解肾脏疾病与心血管和其他类型发病率风险之间的关系的总体目标。特别是，在第三阶段，CRIC的SDCC将继续向CRIC研究网络提供科学、数据分析和后勤支持，因为它继续处理各种高影响的研究领域，并扩大对老年人CKD、中度CKD患者以及CKD患者的发病率负担的重视。CRIC研究队列是一个无与伦比的资源，它还将通过整个肾脏研究界的更多合作以及与世界各地其他流行病学研究的互动，扩大我们开展与CKD相关的科学的能力。

DESCRIPTION (provided by applicant): This is an application from the Center for Clinical Epidemiology and Biostatistics at the University of Pennsylvania to serve as the Scientific and Data Coordinating Center (SDCC) for the Continuation of the Chronic Renal Insufficiency Cohort (CRIC) Study. Chronic renal insufficiency (CRI) affects over 20 million Americans with particular burden among older adults. The morbidity associated with chronic kidney disease (CKD) derives from frequent progression to end-stage renal disease (ESRD), a disproportionate risk of cardiovascular events, and other morbidities associated with disability and high costs of care. A set of etiological factors is being identified as potentially responsible for both progressive renal disease and morbidities in the setting of CKD, especially those operating early in the course of CKD when progression may be forestalled. These factors include clinical, behavioral, and those associated with biomarkers. Characterizing relationships between these risk factors and outcomes will permit development of instruments to predict poor outcomes in patients with CRI and enhance understanding of the etiological mechanisms leading to these outcomes. Improved prediction will allow identification of high-risk subgroups with CRI, thus guiding enrollment into preventive treatment trials and application of preventive therapies. The proposed third phase of CRIC will combine the study of these current CRIC participants along with 1,500 additional study participants to address overarching goals of understanding the relationship between kidney disease and the risks of cardiovascular and other types of morbidity. In particular, during Phase III, CRIC's SDCC will continue to provide scientific, data analytical, and logistical support to the CRIC Research Network as it continues to address a diverse set of high-impact areas of investigation with expanded emphasis on CKD in older adults, patients with moderate levels of CKD, and the burden of morbidity in patients with CKD. The CRIC Study cohort is an unparalleled resource that will also expand our ability to conduct science related to CKD through additional collaborations throughout the renal research community and interactions with other epidemiologic studies worldwide.