Chronic Kidney Disease in Children (CKiD III)

描述（由申请人提供）：儿童慢性肾脏病研究（CKiD）是一项多中心、前瞻性队列研究，研究对象为1至16岁的轻度至中度肾功能受损儿童。两个临床协调中心（CCC）（费城儿童医院（CHOP）和堪萨斯城的儿童慈善医院（CMH））、一个中心实验室（罗切斯特大学）和一个数据协调中心（约翰霍普金斯彭博公共卫生学院）已达成合作协议，以开展这项儿童慢性肾脏疾病的前瞻性研究。自2003年成立以来，CKiD的科学目标一直是确定肾功能下降的风险因素以及肾功能下降对心血管疾病风险因素的影响;生长衰竭及其相关发病率;以及神经认知功能和行为。本申请的目的是申请资金，以便从2013年8月至2018年7月继续进行队列研究。当前提案的目的是评估和提高早期CKD青年CKiD估计公式的准确性和精密度，根据病因、GFR和白蛋白尿水平，根据CKD的肾脏疾病改善全球结局（KDIGO）分类，定义儿童肾脏疾病进展的风险，确定肾小球疾病儿童与非肾小球疾病儿童和非裔美国人中GFR加速和非线性下降的风险因素，并评估体能，随着GFR下降，动脉僵硬度和心肌结构和功能也会下降。中西部临床协调中心主要研究者在儿童肾脏疾病、临床研究设计、招募和保留、研究程序质量控制以及组织CKiD多个参与研究中心的协作方面具有临床专业知识。CKiD研究包括一个地理和种族多样化的队列。CKiD的结构及其对辅助研究的支持继续激发新的方法来识别肾脏疾病进展的风险因素。CKiD的基础设施继续作为初级研究人员职业发展奖励的平台，并为更高级的同事提供辅助R 01。随着更长时间的随访和轻度肾功能不全和肾小球疾病受试者的额外招募，我们将继续表征与CKD进展及其后遗症相关的肾损伤的新生物标志物，为未来的治疗试验提供信息。

DESCRIPTION (provided by applicant): The Chronic Kidney Disease in Children Study (CKiD) is a multi-center, prospective cohort study of children aged 1 to 16 years with mild to moderately impaired kidney function at study entry. Two clinical coordinating centers (CCCs) (at the Children's Hospital of Philadelphia (CHOP), and Children's Mercy Hospital (CMH) in Kansas City), a central laboratory (at the University of Rochester), and a data coordinating center (at Johns Hopkins Bloomberg School of Public Health) have formed a cooperative agreement to conduct this prospective study of chronic kidney disease in children. Since its inception in 2003, the scientific aims of CKiD have been to determine the risk factors for decline in kidney function and the effects of kidney function decline on risk factors for cardiovascular disease; growth failure and its associated morbidity; and neurocognitive function and behavior. The purpose of this application is to request funds to continue the cohort study from August, 2013 to July, 2018. The aims of the current proposal are to assess and improve the accuracy and precision of the CKiD estimating formulas in youth with early CKD, to define the risk of kidney disease progression in children according to the Kidney Disease Improving Global Outcomes (KDIGO) classification of CKD according to Cause, GFR and level of albuminuria, to define risk factors for accelerated and non-linear decline in GFR among strata of children with glomerular compared to non-glomerular diagnoses and in African Americans, and to assess physical performance, arterial stiffness and myocardial structure and function as GFR declines. The Midwest Clinical Coordinating Center Principal Investigator has clinical expertise in kidney disease in children, clinical research design, recruitment and retention, quality control of study procedures, and organization of collaboration across the multiple participating sites in CKiD. The CKiD study encompasses a geographically and racially diverse cohort. The structure of CKiD and its support of ancillary studies continue to stimulate novel approaches to identify risk factors for kidney disease progression. The infrastructure of CKiD continues to serve as a platform for career development awards for junior investigators and ancillary R01's for more senior colleagues. With longer follow-up and additional recruitment of subjects with mild kidney dysfunction and glomerular disease, we will continue to characterize novel biomarkers of kidney injury that are associated with CKD progression and its sequellae to inform future therapeutic trials.