Chronic Kidney Disease (CKD) affects over 26 million Americans. Racial and ethnic disparities exist in the prevalence and incidence of CKD. For example, nationally representative data demonstrate that 19.4% of all African Americans have CKD stage 3 or above, and the most recent data on endstage renal disease (ESRD) indicate African Americans have the highest prevalence and incidence of ESRD in the United States. Unique social, cultural, and behavioral characteristics as well as novel biologic risk factors may contribute to the development and progression of CKD in African Americans, but these pathways have not been adequately defined. The goal of the current grant application is to develop a chronic kidney disease (CKD) working group to evaluate CKD and CKD risk factors among the Jackson Heart Study (JHS) cohorts, to assess risk factors for the progression of CKD and development of endstage renal disease (ESRD), and to determine the influence of CKD on development of cardiovascular disease (CVD) and death. Although much is known regarding disparities in the incidence of ESRD, less is known regarding the contribution of differences in novel biologic, behavioral, and social/cultural risk factors to the development of CKD in African Americans. JHS will provide a NIH-funded cohort with which to study the association of CKD and CVD outcomes and death among a population of African Americans.
The specific aims of the proposal are:
Aim 1 : Develop infrastructure for a highly-functioning diverse, national CKD working group for the Jackson Heart Study with expertise in health disparities, epidemiology, and biostatistics;
Aim 2 : Examine the association of novel and traditional risk factors for CKD, progression of CKD, and ESRD in the JHS cohort.
Aim 3 : Evaluate the relationship of CKD with traditional CVD risk factors, intermediate cardiac outcomes, incident CVD and death in the JHS cohort. This research will develop 1) the infrastructure for a successful productive CKD working group, 2) a research agenda that will elucidate determinants of development, progression and outcomes of CKD in the JHS and 3) a future workforce capable of conducting high quality research on the interrelationship of CKD and CVD, thereby improving the public health of African Americans.

Public Health Relevance

/RELEVANCE STATEMENT Background and Rationale: Chronic Kidney Disease (CKD) is an important public health problem due its high prevalence, morbidity, and poor health outcomes. Racial and ethnic minorities are disproportionately affected with CKD and currently, African Americans have the highest incidence of kidney failure in the world and are less likely to be transplanted. Identification of reversible risk factors early in the course of disease would help to identify and target patients who are at high risk for potential interventions. This application will develop the infrastructure or a national Jackson Heart Study CKD working group that will evaluate novel and non-traditional risk factors for CKD. To that end the specific aims are: Aim 1: Develop infrastructure for a highly-functioning diverse, national CKD working group for the Jackson Heart Study with expertise in health disparities, epidemiology, and biostatistics;Aim 2: Examine the association of novel and traditional risk factors for CKD, progression of CKD, and ESRD in the JHS cohort. Aim 3: Evaluate the relationship of CKD with traditional CVD risk factors, intermediate cardiac outcomes, incident CVD and death in the JHS cohort. This research will develop 1) the infrastructure for a successful productive CKD working group, 2) a research agenda that will elucidate determinants of development, progression and outcomes of CKD in the JHS and 3) a future workforce capable of conducting high quality research on the interrelationship of CKD and CVD, thereby improving the public health of African Americans.

Agency
National Institute of Health (NIH)
Type
Research Project (R01)
Project #
5R01DK102134-02
Application #
8735949
Study Section
Special Emphasis Panel (ZHL1)
Program Officer
Flessner, Michael Francis
Project Start
Project End
Budget Start
Budget End
Support Year
2
Fiscal Year
2014
Total Cost
Indirect Cost
Name
University of Washington
Department
Internal Medicine/Medicine
Type
Schools of Medicine
DUNS #
City
Seattle
State
WA
Country
United States
Zip Code
98195
Crews, Deidra C; Liu, Yang; Boulware, L Ebony (2014) Disparities in the burden, outcomes, and care of chronic kidney disease. Curr Opin Nephrol Hypertens 23:298-305
Naik, Rakhi P; Derebail, Vimal K; Grams, Morgan E et al. (2014) Association of sickle cell trait with chronic kidney disease and albuminuria in African Americans. JAMA 312:2115-25