Chronic kidney disease (CKD) is a global public health epidemic, affecting 10-16% of the adult population in Asia, Europe, and North America. The clinical impact of CKD is substantial: risks of end stage renal disease (ESRD), cardiovascular disease (CVD), and premature mortality are all heightened. Despite substantial progress, there are several unanswered questions in the field of CKD epidemiology, in part due to the heterogeneity of analytic strategies, measurement of kidney disease markers, and outcome definitions used in published studies. A rigorous, uniform approach using extensive, globally collected data is needed to solidify the foundation of evidence for CKD management, research initiatives, and strategies for prevention. The CKD Prognosis Consortium (CKD-PC) was formed in 2009 using seed money from the National Kidney Foundation and now comprises ~200 investigators from 50 cohorts world-wide; new cohorts join each year. With estimated glomerular filtration rate (eGFR) and albuminuria measures in >2.5 million participants representing general, high cardiovascular risk, and CKD populations, the CKD-PC developed a track record of producing high impact papers. CKD-PC complements established CKD cohorts by representing a broad range of global populations, spanning the full range of kidney function, and meta-analyzing where appropriate data exist. Using a fluid structure with uniform, centralized analytics, CKD-PC will pursue three broad aims:
Aim 1 : To determine the relationship of CKD progression to risk of ESRD, mortality, and other outcomes. This will inform selection of surrogate outcomes for clinical trials and tracking of patients with respect to CKD progression.
Aim 2 : To develop risk prediction models for CKD-related outcomes (e.g., CVD and ESRD) across a range of patient populations. These risk scores will inform clinical decision making.
Aim 3 : To pursue additional high priority topics in close collaboration with consortium members. We are expanding the range of outcomes, risk factors, and methodologic research.
The aims comprise 18 manuscript topics; we plan to publish at least four rigorous meta- analyses each year. At all steps, we will work to improve standardization of CKD measures and outcomes, develop rigorous and innovative statistical methods, and share analytical tools and techniques across cohorts and with the public. Previous work by the CKD-PC has already proved useful for clinical guidelines and FDA evaluation of CKD progression in clinical trials. This grant would fund sustained productivity addressing important questions.

Public Health Relevance

Prognosis Consortium (CKD-PC) will use state-of-the-art analysis methods to address pressing questions needed to optimize CKD care and research. The consortium comprises ~200 investigators from 50 cohorts world-wide; new cohorts join each year. With estimated glomerular filtration rate (eGFR) and albuminuria measures in >2.5 million participants representing general, high cardiovascular risk, and CKD populations, the CKD-PC developed a track record of producing high impact papers and has a plan for advancing knowledge related to CKD progression, risk scores and additional pressing questions.

Agency
National Institute of Health (NIH)
Institute
National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK)
Type
Research Project (R01)
Project #
5R01DK100446-04
Application #
9251808
Study Section
Kidney, Nutrition, Obesity and Diabetes (KNOD)
Program Officer
Kusek, John W
Project Start
2014-03-28
Project End
2018-02-28
Budget Start
2017-03-01
Budget End
2018-02-28
Support Year
4
Fiscal Year
2017
Total Cost
$577,541
Indirect Cost
$209,135
Name
Johns Hopkins University
Department
Public Health & Prev Medicine
Type
Schools of Public Health
DUNS #
001910777
City
Baltimore
State
MD
Country
United States
Zip Code
21205
Ishigami, Junichi; Grams, Morgan E; Chang, Alexander R et al. (2017) CKD and Risk for Hospitalization With Infection: The Atherosclerosis Risk in Communities (ARIC) Study. Am J Kidney Dis 69:752-761
Grams, Morgan E; Yang, Wei; Rebholz, Casey M et al. (2017) Risks of Adverse Events in Advanced CKD: The Chronic Renal Insufficiency Cohort (CRIC) Study. Am J Kidney Dis 70:337-346
Herrington, William G; Smith, Margaret; Bankhead, Clare et al. (2017) Body-mass index and risk of advanced chronic kidney disease: Prospective analyses from a primary care cohort of 1.4 million adults in England. PLoS One 12:e0173515
Carrero, Juan Jesús; Grams, Morgan E; Sang, Yingying et al. (2017) Albuminuria changes are associated with subsequent risk of end-stage renal disease and mortality. Kidney Int 91:244-251
Matsushita, Kunihiro; Ballew, Shoshana H; Coresh, Josef et al. (2017) Measures of chronic kidney disease and risk of incident peripheral artery disease: a collaborative meta-analysis of individual participant data. Lancet Diabetes Endocrinol 5:718-728
Ballew, Shoshana H; Chen, Yan; Daya, Natalie R et al. (2017) Frailty, Kidney Function, and Polypharmacy: The Atherosclerosis Risk in Communities (ARIC) Study. Am J Kidney Dis 69:228-236
Chang, Alex R; Sang, Yingying; Leddy, Julia et al. (2016) Antihypertensive Medications and the Prevalence of Hyperkalemia in a Large Health System. Hypertension 67:1181-8
Grams, Morgan E; Sang, Yingying; Levey, Andrew S et al. (2016) Kidney-Failure Risk Projection for the Living Kidney-Donor Candidate. N Engl J Med 374:411-21
Naimark, David M J; Grams, Morgan E; Matsushita, Kunihiro et al. (2016) Past Decline Versus Current eGFR and Subsequent Mortality Risk. J Am Soc Nephrol 27:2456-66
Grams, Morgan E; Sang, Yingying; Coresh, Josef et al. (2016) Candidate Surrogate End Points for ESRD after AKI. J Am Soc Nephrol 27:2851-9

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