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, but options for CKD prevention and treatment remain limited. The proposed study is a renewal of R01 DK100446, a grant which funds the CKD Prognosis Consortium (CKD-PC). CKD-PC was formed in 2009 and now includes data on >11 million participants from more than 70 cohorts spanning 40 countries with a strong track record of producing high impact meta-analyses (2 in NEJM, 3 in Lancet, 4 in JAMA, 1 in BMJ, 4 in Kidney Int, 2 in JASN, 2 in AJKD, and 1 in Lancet Diabetes Endocrinol). CKD-PC complements established cohorts in CKD by representing a broad range of global populations; spanning the full range of kidney function; devoting tenacious attention to harmonization, exploration of heterogeneity, and calibration; and meta-analyzing results where appropriate. In this new funding period, we will continue to mentor and recruit investigators and cohorts from around the world, grow substantially, and innovate with new areas of emphasis in the following aims:
Aim 1. To determine risk of incident CKD and CKD progression associated with clinical markers across a range of patient populations.
Aim 2. To evaluate the risk of non-kidney outcomes associated with eGFR and albuminuria.
Aim 3. To develop risk calculators for CKD incidence, CKD progression, and ESRD overall and in specific populations such as patients with heart failure. In all aims, we will continue to implement and expand upon our innovative meta-analysis methods, including Markov processes, simulations, and standard incorporation of competing risks. We remain flexible and efficient in responding to high priority topics set forth by guideline organizations (e.g., Kidney Disease: Improving Global Outcomes), regulatory agencies (e.g., US Food and Drug Administration) and major societies (e.g., International Society of Nephrology, National Kidney Foundation, and American Society of Nephrology) as well as informing global health metrics and economic efforts (e.g., Institute for Health Metrics and Evaluation Global Burden of Disease). Our overarching goal is to advance the understanding, care, and outcomes of CKD patients and global populations, using an investigator-led global consortium and the data and expertise from ~300 international collaborators.

Public Health Relevance

Chronic kidney disease (CKD) is a global public health epidemic, affecting 10-16% of the adult population, with substantial risks but limited prevention and treatment options. The CKD Prognosis Consortium (CKD-PC) was formed in 2009 and now includes data on over 11 million participants from more than 70 cohorts spanning 40 countries. Work by the CKD-PC has had enormous clinical impact, providing evidence for a global definition of CKD, the acceptance of new surrogate endpoints in CKD clinical trials, and development and validation of important CKD risk calculators; the proposed study will build upon previous successes and allow the consortium to continue to grow, innovate, and answer high priority questions facing the global population.

National Institute of Health (NIH)
National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK)
Research Project (R01)
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Study Section
Kidney, Nutrition, Obesity and Diabetes Study Section (KNOD)
Program Officer
Chan, Kevin E
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Johns Hopkins University
Public Health & Prev Medicine
Schools of Public Health
United States
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Grams, Morgan E; Sang, Yingying; Ballew, Shoshana H et al. (2018) Predicting timing of clinical outcomes in patients with chronic kidney disease and severely decreased glomerular filtration rate. Kidney Int 93:1442-1451
Chronic Kidney Disease Prognosis Consortium (2018) Grams ME, Sang Y, Ballew SH, et al, for the Chronic Kidney Disease Prognosis Consortium. Predicting timing of clinical outcomes in patients with chronic kidney disease and severely decreased glomerular filtration rate. Kidney Int. 2018;93:1442-1451. Kidney Int 94:1025-1026
Evans, Marie; Grams, Morgan E; Sang, Yingying et al. (2018) Risk Factors for Prognosis in Patients With Severely Decreased GFR. Kidney Int Rep 3:625-637
Inker, Lesley A; Grams, Morgan E; Levey, Andrew S et al. (2018) Relationship of Estimated GFR and Albuminuria to Concurrent Laboratory Abnormalities: An Individual Participant Data Meta-analysis in a Global Consortium. Am J Kidney Dis :
Shin, Jung-Im; Luo, Shengyuan; Alexander, G Caleb et al. (2018) Direct Oral Anticoagulants and Risk of Acute Kidney Injury in Patients With Atrial Fibrillation. J Am Coll Cardiol 71:251-252
Kovesdy, Csaba P; Matsushita, Kunihiro; Sang, Yingying et al. (2018) Serum potassium and adverse outcomes across the range of kidney function: a CKD Prognosis Consortium meta-analysis. Eur Heart J 39:1535-1542
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
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
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
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

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