Chronic Kidney Disease in Children (CKiD)

儿童慢性肾脏病 (CKiD)

基本信息

批准号：
7901931
负责人：
Bradley Alan Warady
金额：
$ 52.5万
依托单位：
CHILDREN'S MERCY HOSP (KANSAS CITY, MO)
依托单位国家：
美国
项目类别：
财政年份：
2009
资助国家：
美国
起止时间：
2009-09-27 至 2012-09-26
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/7901931
关键词：
16 year old Albumins Ambulatory Blood Pressure Monitoring Area Atherosclerosis Biochemical Biological Assay Blood Pressure Body Composition Brain Cachexia Calcium Cardiomyopathies Cardiovascular Diseases Carotid Arteries Child Childhood Chronic Chronic Kidney Failure Chronic Kidney Insufficiency Development Dietary intake Electrolytes Enrollment Evaluation Functional disorder Generations Glomerular Filtration Rate Growth Height Hematocrit procedure Hemoglobin Hemoglobin concentration result Histologic Histology Hour Hyperparathyroidism Incidence Inflammation Joints Kidney Kidney Failure Left Left Ventricular Hypertrophy Measures Morbidity - disease rate Neurocognitive Neuropeptides Nutritional Nutritional status Osteogenesis Outcome Parathyroid Hormones Patients Phosphorus Physical Examination Prevalence Proteinuria Race Renal Osteodystrophy Risk Factors Role Serum Serum Albumin Severities Somatotropin Testing Thick Ultrasonography Weight bone cohort cytokine follow-up hormone resistance hormone therapy human PTH protein indexing intima media mortality neurocognitive test nutrition urinary

项目摘要

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 orevalence 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-ventricularmass 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.

该应用程序是 NAPRTCS 26 个中心的共同努力，题为“慢性肾功能不全” NAPRTCS 患者的 (CRI)。我们将招募 300 名儿童（1-16 岁）进行肾小球滤过测量速率 (GFR) 为 25-75 mL/min/1.73m2。年度 GFR 和 6 个月体检的随访血红蛋白、电解质、血清、白蛋白、血清钙、血清磷的测定，甲状旁腺激素和尿指数将检验第一个假设，即该队列将最准确地定义 CRI 进展的速率和危险因素，并且这种进展将是相关的与蛋白尿、白蛋白、血压、营养状况、生长和甲状旁腺功能亢进有关。测试第二个假设是轻度 CRI 的儿童会患心血管疾病，并且其与 CRI 进展相关的等效性和严重性增加，我们将进行基线每年 24 小时动态血压监测、超声心动图评估确定左心室质量和左心室功能，以及颈动脉 B 型超声检查确定 IMT 和颈动脉顺应性。检验第三个假设：神经认知 CRI 儿童的结局受到肾功能不全进展的影响，肾功能不全是一系列将在研究开始时以及第 6、12 和 24 个月时进行经过验证的神经认知测试，以评估大脑功能的许多皮质和皮质下区域。检验第四个假设，即慢性炎症会导致恶病质、生长激素抵抗和生长迟缓，我们将检查循环细胞因子和神经肽浓度对饮食摄入、营养的影响和生长参数以及生长激素轴扰动和生长反应激素疗法。最后，为了检验第五个假设，即骨组织学之间存在相关性， PTH 的血清浓度和测量的 GFR，我们将测量和表征生化和肾性骨营养不良的组织学特征并确定 PTH 的血清浓度与正常的骨形成率相关。