Chronic Kidney Disease in Children (CKiD III)

描述(由申请人提供)：儿童慢性肾脏疾病研究(CKiD)是一项多中心的前瞻性队列研究，研究对象为1至16岁的儿童，研究开始时肾功能轻度至中度受损。两个临床协调中心(CCCS)(费城儿童医院(CHOP)和堪萨斯城儿童慈悲医院(CMH))、一个中心实验室(罗切斯特大学)和一个数据协调中心(约翰霍普金斯大学彭博公共卫生学院)达成合作协议，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危险因素以及肾功能下降对心血管疾病危险因素的影响；生长障碍及其相关发病率；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。当前建议的目的是评估和提高青年早期CKD患者CKiD估计公式的准确性和精密度，根据肾脏疾病改善全球预后(KDIGO)根据病因、GFR和蛋白尿水平对CKD进行的分类，确定儿童肾脏疾病进展的风险，确定与非肾小球诊断的儿童和非裔美国人相比，肾小球儿童各阶层GFR加速和非线性下降的危险因素，并评估随着GFR下降的体能、动脉僵硬和心肌结构和功能。中西部临床协调中心首席研究员在儿童肾脏疾病、临床研究设计、招募和保留、研究程序的质量控制以及CKiD多个参与站点的协作组织方面拥有临床专业知识。CKiD的研究涵盖了不同地理和种族的队列。CKiD的结构及其对辅助研究的支持继续刺激新的方法来确定肾脏疾病进展的危险因素。犯罪现场调查处的基础设施继续作为初级调查人员职业发展奖的平台，并为更资深的同事提供辅助R01‘S奖。随着更长时间的随访和对轻度肾功能障碍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脏损伤的新生物标记物，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.