Chronic Kidney Disease in Children Study (C-Kid)

儿童慢性肾脏病研究 (C-Kid)

• 批准号: 6804463
• 负责人: SUSAN L. FURTH
• 金额: $ 73.1万
• 依托单位: JOHNS HOPKINS UNIVERSITY
• 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/6804463
• 关键词: adolescence (12-20); cardiovascular disorder; child (0-11); child physical development; children; chronic disease /disorder; clinical research; cognition; comorbidity; cooperative study; data collection methodology /evaluation; depression; disease /disorder onset; disease /disorder proneness /risk; electroencephalography; ethnic group; experimental designs; glomerular filtration rate; human subject; inflammation; kidney disorder; kidney function; kidney pharmacology; longitudinal human study; magnetic resonance imaging; neurophysiology; neuropsychological tests; patient oriented research; proteinuria; socioeconomics

DESCRIPTION (provided by applicant): Chronic kidney disease (CKD) and its metabolic derangements substantially affect the well-being of children. In order to define the nature, magnitude, and temporal evolution of the adverse effects of progressive CKD, we propose to conduct a prospective study of CKD in children to determine (1) risk factors for accelerated decline in renal function; (2) incidence, nature, magnitude and temporal evolution of impaired brain function and structure; (3) prevalence of risk factors for cardiovascular disease (CVD); and (4) implications of growth failure and its treatment on morbidity. The Prospective Study of Chronic Kidney Disease in Children (C-Kid) is a longitudinal, observational study of 600 children, aged < 19 yrs with mildly to moderately impaired kidney function (estimated glomerular filtration rate (GFR) 30-75 ml/min/1.73m2). The follow-up period will be 2.5 to 4.5 years. At enrollment, and at annual visits thereafter, selected exposures will be obtained on participants, including sociodemographic characteristics, family history, health care utilization, environmental exposures and medication use using standardized questionnaires. Standardized blood pressure, growth and nutritional assessments, metabolic status, measures of anemia, dyslipidemia, measures of microinflammation, insulin resistance and proteinuria will also be measured. Level of kidney function (GFR) will be measured annually by plasma disappearance of iohexol. The primary outcomes of interest will be the temporal evolution of subclinical measures and clinical events associated with CKD progression as measured by decline in GFR, growth failure and its treatment, neurocognitive and behavioral deficits and cardiovascular disease, specified in our aims below. Potential analyses that could be conducted using the C-Kid infrastructure to explore risk-factor disease relationships include traditional prospective cohort analyses where putative risk factors are measured in participants at baseline; nested case-control studies in which laboratory studies are performed on stored baseline specimens in cases (e.g. rapid progressors) and appropriately matched controls (e.g. non-progressors); and cross-cohort analyses utilizing parallel cohorts.

描述（由申请人提供）： 慢性肾脏病（CKD）及其代谢紊乱严重影响儿童的健康。为了明确进展性 CKD 不良反应的性质、程度和时间演变，我们建议对儿童 CKD 进行前瞻性研究，以确定 (1) 肾功能加速衰退的危险因素； (2) 脑功能和结构受损的发生率、性质、程度和时间演变； (3)心血管疾病(CVD)危险因素的患病率； (4) 生长障碍及其治疗对发病率的影响。 儿童慢性肾脏病前瞻性研究 (C-Kid) 是一项纵向观察性研究，对象为 600 名年龄 < 19 岁、肾功能轻度至中度受损的儿童（估计肾小球滤过率 (GFR) 30-75 毫升/分钟/ 1.73平方米）。随访期为2.5至4.5年。在登记时以及此后的年度访问中，将使用标准化问卷获得参与者的选定暴露情况，包括社会人口特征、家族史、医疗保健利用、环境暴露和药物使用情况。还将测量标准化血压、生长和营养评估、代谢状态、贫血测量、血脂异常、微炎症测量、胰岛素抵抗和蛋白尿。每年通过碘海醇的血浆消失来测量肾功能水平（GFR）。感兴趣的主要结果将是与 CKD 进展相关的亚临床指标和临床事件的时间演变，通过 GFR 下降、生长障碍及其治疗、神经认知和行为缺陷以及心血管疾病来衡量，具体见我们下面的目标。可以使用 C-Kid 基础设施进行潜在分析，以探索风险因素疾病关系，包括传统的前瞻性队列分析，其中在基线时测量参与者的假定风险因素；巢式病例对照研究，其中对病例（例如快速进展者）和适当匹配的对照（例如非进展者）中储存的基线标本进行实验室研究；以及利用平行队列的跨队列分析。