Chronic Renal Insufficiency in NAPRTCS Patients

NAPRTCS 患者的慢性肾功能不全

• 批准号: 6712626
• 负责人: Bradley Alan Warady
• 金额: $ 42.47万
• 依托单位: CHILDREN'S MERCY HOSP (KANSAS CITY, MO)
• 依托单位国家: 美国
• 财政年份: 2003
• 资助国家: 美国
• 起止时间: 2003-09-30 至 2008-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6712626
• 关键词: adolescence (12-20); albumins; blood pressure; bone development; cachexia; cardiovascular disorder; child (0-11); child physical development; children; chronic renal failure; clinical research; comorbidity; cooperative study; cytokine; echocardiography; glomerular filtration rate; hormone therapy; human morbidity; human mortality; human subject; hyperparathyroidism; immunologic assay /test; longitudinal human study; neuropeptides; neurophysiology; neuropsychological tests; nutrition; parathyroid hormones; patient oriented research; proteinuria; renal rickets; ultrasound; ventricular hypertrophy

DESCRIPTION (provided by applicant): This application, a joint effort of 26 centers of the NAPRTCS, is entitled "Chronic Renal Insufficiency (CRI) in NAPRTCS Patients. We will enroll 300 children (1-16 years) with measured glomerular filtration rates (GFR) of 25-75 mL/min/1.73m2. Follow-up with annual GFR and 6 month physical examinations and determinations of hemoglobin, electrolytes, serum, albumin, serum calcium, serum phosphorus, parathyroid hormone and urinary indices will test the 1st hypothesis that this cohort will most accurately define the rate of and the risk factors for progression of CRI, and that this progression will be correlated with proteinuria, albumin, blood pressure, nutritional status, growth and hyperparathyroidism. To test the 2nd hypothesis that cardiovascular disease develops in children with mild CRI and that its prevalence and severity increase in association with the progression of CRI, we will perform baseline and annual 24-hour ambulatory blood pressure monitoring, echocardiographic assessments to determine left-ventricular mass and LV function, and B-mode ultrasound of the carotid artery to determine the IMT and carotid artery compliance. To test the 3rd hypothesis that the neurocognitive outcome of children with CRI is influenced by the progression of renal insufficiency, a battery of validated neurocognitive tests will be conducted at study entry and at 6, 12 and 24 months to assess many cortical and subcortical areas of brain function. To test the 4th hypothesis that chronic inflammation contributes to cachexia, growth hormone resistance and growth retardation, we will examine the impact of circulating cytokine and neuropeptide concentrations on dietary intake, nutritional and growth parameters as well as growth hormone axis pertubations and responsiveness to growth hormone therapy. Finally, to test the 5th hypothesis that a correlation exist between bone histology, serum concentration of PTH and measured GFR, we will measure and characterize the biochemical and histologic features of renal osteodystrophy and determine the serum concentrations of PTH that are associated with normal rates of bone formation.

描述（由申请人提供）： 这项应用是NAPRTC的26个中心的共同努力，标题为“ NAPRTCS患者的慢性肾功能不全（CRI）。我们将招募300名儿童（1-16岁），测量的肾小球过滤率（GFR）为25-75 ml/1.73m2mm2。 serum, albumin, serum calcium, serum phosphorus, parathyroid hormone and urinary indices will test the 1st hypothesis that this cohort will most accurately define the rate of and the risk factors for progression of CRI, and that this progression will be correlated with proteinuria, albumin, blood pressure, nutritional status, growth and hyperparathyroidism. To test the 2nd hypothesis that cardiovascular disease患有轻度CRI的儿童的发展，其患病率和严重程度随CRI的发展相关性，我们将进行基线和年度24小时的卧床血压监测，超声心动图评估，以确定腹膜质量和LV功能，以及B模式超声，以确定IMT和Carotid Artery Artery Artery Arter Artery Artery。为了检验第三个假设，即CRI儿童的神经认知结果受肾功能不全的进展，在研究入学时将进行一系列经过验证的神经认知测试，并在6、12和24个月进行评估，以评估许多大脑功能的皮质和皮层皮质和亚皮层区域。为了检验第四个假设，即慢性炎症有助于恶病恶检查，生长激素抗性和生长迟缓，我们将研究循环细胞因子和神经肽浓度对饮食摄入，营养和生长参数以及生长激素轴承的影响以及对生长激素治疗的影响。最后，为了检验第五个假设，即骨骼组学，PTH的血清浓度和测量的GFR之间存在相关性，我们将测量和表征肾脏骨肌营养体的生化和组织学特征，并确定与正常骨形成率相关的PTH血清浓度。