Chronic Kidney Disease Prognosis Consortium

描述（由申请人提供）：慢性肾脏疾病（CKD）是一种全球性的公共卫生流行病，影响了亚洲、欧洲和北美10-16%的成年人。CKD的临床影响是巨大的：终末期肾脏疾病（ESRD）、心血管疾病（CVD）和过早死亡的风险都增加了。尽管取得了实质性进展，但在CKD流行病学领域仍有几个未解决的问题，部分原因是由于分析策略、肾脏疾病标志物的测量和已发表研究中使用的结果定义的异质性。需要一种严格、统一的方法，使用广泛的、全球收集的数据来巩固CKD管理、研究计划和预防策略的证据基础。CKD预后联盟（CKD- pc）成立于2009年，由国家肾脏基金会提供种子资金，目前包括来自全球50个队列的约200名研究人员；每年都有新的队列加入。通过估计250万名参与者的肾小球滤过率（eGFR）和蛋白尿，这些参与者代表了一般、高危心血管疾病和CKD人群，CKD- pc开发了高影响力论文的记录。CKD- pc通过代表广泛的全球人群来补充已建立的CKD队列，涵盖肾功能的全部范围，并在适当的数据存在时进行荟萃分析。采用统一、集中分析的流体结构，CKD- pc将实现三个主要目标：目标1：确定CKD进展与ESRD风险、死亡率和其他结局的关系。这将为临床试验替代结果的选择和CKD进展患者的跟踪提供信息。目标2：在一系列患者群体中建立ckd相关结果（例如，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：与联盟成员密切合作，追求其他高优先级主题。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个稿件题目；我们计划每年至少发表四篇严谨的元分析。在所有步骤中，我们将努力提高CKD测量和结果的标准化，开发严格和创新的统计方法，并在队列和公众之间分享分析工具和技术。CKD- pc先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。这笔赠款将资助解决重要问题的持续生产力。

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.