American Indian chronic Renal insufficiency cohort study (AI-CRIC study)

Mark L Unruh,Larissa Myaskovsky,David Johnson,Soraya Arzhan,Linda Son-Stone,Robert G Nelson,Harold I Feldman,Helen C Looker,Vernon S Pankratz,Thomas Faber,Vallabh O Shah

doi:10.1186/s12882-020-01954-y

Abstract

BackgroundChronic kidney disease (CKD) is an increasing epidemic globally that is associated with adverse health outcomes including end stage kidney disease (ESKD), cardiovascular disease (CVD), and death. American Indians (AIs) have a higher prevalence of CKD than most other racial/ethnic groups, due in part to a high prevalence of type 2 diabetes. Other genetic and environmental factors not yet identified may also contribute to the disproportionate burden of CKD in AIs.MethodWe will establish 3 clinical centers to recruit AIs from the Southwest United States (US) to expand the Chronic Renal Insufficiency Cohort (CRIC) study. We will follow the current CRIC protocol for kidney and cardiovascular measures and outcomes, which include ambulatory monitoring of kidney function and the use of mobile health technologies for CVD sub-phenotyping, and compare the outcomes in AIs with those in other racial/ethnic groups in CRIC.DiscussionAI-CRIC will identify the role of various risk factors for rapid loss of kidney function among AIs of the Southwest US. In addition, to better understand the natural history of CKD and CVD in this high-risk population, we will identify unique risk factors for CKD and CVD progression in AIs. We will also compare event rates and risk factors for kidney and cardiovascular events in AIs with the other populations represented in CRIC.

Highlights

Chronic kidney disease (CKD) is an increasing epidemic globally that is associated with adverse health outcomes including end stage kidney disease (ESKD), cardiovascular disease (CVD), and death
American Indian Chronic Renal Insufficiency Cohort (AI-Chronic Renal Insufficiency Cohort (CRIC)) will identify the role of various risk factors for rapid loss of kidney function among American Indian (AI) of the Southwest United States (US)
We will compare event rates and risk factors for kidney and cardiovascular events in AIs with the other populations represented in CRIC

Summary

Introduction

Chronic kidney disease (CKD) is an increasing epidemic globally that is associated with adverse health outcomes including end stage kidney disease (ESKD), cardiovascular disease (CVD), and death. Other genetic and environmental factors not yet identified may contribute to the disproportionate burden of CKD in AIs. Chronic kidney disease (CKD) is an increasing epidemic affecting people globally [1]. Associated morbidity, mortality and economic burden mostly derive from progression to end stage kidney disease (ESKD) and cardiovascular disease (CVD). In addition to continuing the search for circulating and genetic markers of CKD progression, new paradigms have emerged to identify the role of subclinical risk factors (e.g., Cystatin C) for rapid loss of kidney function among AIs. Measurement of kidney function variability over time and detection of acute decrements in kidney function will be an important focus of the AI-CRIC Study. Several recent clinical trials examining treatments to slowing down CKD progression have failed to show outcome benefit in part because of the inability to identify prospectively, and randomize those at greatest risk of rapid progression while receiving standard of care treatment [8, 9]

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