The Chronic Kidney Disease in Children Study (CKiD) is a multi-center, prospective cohort study of children aged 1 to 16 years with mild to moderately impaired kidney function at study entry. Two clinical coordinating centers (CCCs) (at the Children's Hospital of Philadelphia (CHOP), and Children's Mercy Hospital (CMH) in Kansas City), a central laboratory (at the University of Rochester), and a data coordinating center (at Johns Hopkins Bloomberg School of Public Health) have formed a cooperative agreement to conduct this prospective study of chronic kidney disease in children. Since its inception in 2003, the scientific aims of CKiD have been to determine the risk factors for decline in kidney function and the effects of kidney function decline on risk factors for cardiovascular disease;growth failure and its associated morbidity;and neurocognitive function and behavior. The purpose of this application is to request funds to continue the cohort study from August, 2013 to July, 2018.
The aims of the current proposal are to assess and improve the accuracy and precision of the CKiD estimating formulas in youth with early CKD, to define the risk of kidney disease progression in children according to the Kidney Disease Improving Global Outcomes (KDIGO) classification of CKD according to Cause, GFR and level of albuminuria, to define risk factors for accelerated and non-linear decline in GFR among strata of children with glomerular compared to non-glomerular diagnoses and in African Americans, and to assess physical performance, arterial stiffness and myocardial structure and function as GFR declines. The Midwest Clinical Coordinating Center Principal Investigator has clinical expertise in kidney disease in children, clinical research design, recruitment and retention, quality control of study procedures, and organization of collaboration across the multiple participating sites in CKiD. The CKiD study encompasses a geographically and racially diverse cohort. The structure of CKiD and its support of ancillary studies continue to stimulate novel approaches to identify risk factors for kidney disease progression. The infrastructure of CKiD continues to serve as a platform for career development awards for junior investigators and ancillary R01's for more senior colleagues. With longer follow-up and additional recruitment of subjects with mild kidney dysfunction and glomerular disease, we will continue to characterize novel biomarkers of kidney injury that are associated with CKD progression and its sequellae to inform future therapeutic trials.

Public Health Relevance

Children with chronic kidney disease (CKD) pose unique challenges to the health care system, which must address not only the primary kidney disorder, but the many extra-renal manifestations that influence growth, development, risk for cardiovascular disease and a high mortality rate in young adulthood. The CKiD study is a landmark cohort study of children with CKD, having rallied 54 pediatric nephrology centers across the US and Canada to recruit and study almost 800 children with mild to moderate CKD. From 2013 to 2018, the Midwest Coordinating Center (MCC) will continue to coordinate the study visits in their component of this group of children, with the following long term goals: to identify novel risk factors for kidney function decline and potential targets for therapeutic intervention, to understand the processes that result in a high prevalence of heart disease, and to identify the adverse effects of CKD progression on growth, cognitive function, and the quality of life in children with chronic kidney disease.

Agency
National Institute of Health (NIH)
Institute
National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK)
Type
Research Project--Cooperative Agreements (U01)
Project #
2U01DK066143-11
Application #
8581783
Study Section
Special Emphasis Panel (ZDK1-GRB-9 (M3))
Program Officer
Moxey-Mims, Marva M
Project Start
2003-09-30
Project End
2018-07-31
Budget Start
2013-08-01
Budget End
2014-07-31
Support Year
11
Fiscal Year
2013
Total Cost
$955,945
Indirect Cost
$160,884
Name
Children's Mercy Hosp (Kansas City, MO)
Department
Type
DUNS #
073067480
City
Kansas City
State
MO
Country
United States
Zip Code
64108
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Zhong, Yichen; Muñoz, Alvaro; Schwartz, George J et al. (2014) Nonlinear trajectory of GFR in children before RRT. J Am Soc Nephrol 25:913-7
Rodig, Nancy M; McDermott, Kelly C; Schneider, Michael F et al. (2014) Growth in children with chronic kidney disease: a report from the Chronic Kidney Disease in Children Study. Pediatr Nephrol 29:1987-95
Flynn, Joseph T; Ng, Derek K; Chan, Grace J et al. (2014) The effect of abnormal birth history on ambulatory blood pressure and disease progression in children with chronic kidney disease. J Pediatr 165:154-162.e1
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Mitsnefes, Mark; Scherer, Philipp E; Friedman, Lisa Aronson et al. (2014) Ceramides and cardiac function in children with chronic kidney disease. Pediatr Nephrol 29:415-22
Nehus, Edward; Furth, Susan; Warady, Bradley et al. (2014) Correlates of leptin in children with chronic kidney disease. J Pediatr 165:825-9
Hartung, Erum A; Matheson, Matthew; Lande, Marc B et al. (2014) Neurocognition in children with autosomal recessive polycystic kidney disease in the CKiD cohort study. Pediatr Nephrol 29:1957-65
Kupferman, Juan C; Aronson Friedman, Lisa; Cox, Christopher et al. (2014) BP control and left ventricular hypertrophy regression in children with CKD. J Am Soc Nephrol 25:167-74
Barletta, Gina-Marie; Flynn, Joseph; Mitsnefes, Mark et al. (2014) Heart rate and blood pressure variability in children with chronic kidney disease: a report from the CKiD study. Pediatr Nephrol 29:1059-65

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