CRIC and CKiD (Chronic Kidney Disease Studies)
There are two longitudinal studies for Chronic Kidney Disease (CKD). Ancillary studies can be set up to share the collected data, bio samples, or even request additional data to be collected. These Ancillary studies can be funded through normal channels, NIDDK, ASN, VA, etc. Approval to use the data should be requested 3-4 months before funding submission deadline. Funding can be through educational grants, K awards (e.g. K23, K25) or R awards (e.g. R01, R21).
Established in 2001 by the National Institute of Diabetes, Digestive, and Kidney Diseases (NIDDK) to improve the understanding of chronic kidney disease (CKD) and related cardiovascular illness. The study’s goals are:
- To examine risk factors for progression of CKD and cardiovascular disease,
- To develop models that identify high-risk subgroups,
- To assist in the development of treatment trials and therapies.
The CRIC Study initially enrolled over 3939 people with CKD who remain in long-term follow-up. Between July 2013 and August 2015, an additional 1560 people with CKD were invited to join the study with an emphasis on older Americans. The focus of the study was modified to emphasize early forms of CKD and the impact of CKD on multiple dimensions of health status. Follow-up of study participants continues at eleven CRIC Study Centers.
The CKiD Study is a NIH-funded, multicenter, prospective cohort study of children aged 1 to 16 years with mild to moderate impaired kidney function. The primary goals of CKiD are to determine the risk factors for decline in renal function and to define how progressive decline in renal function impacts biomarkers of risk factors for cardiovascular disease; neurocognitive function and behavior; and growth failure and its associated morbidity. Two clinical coordinating centers (CCCs) (at Children’s Hospital of Philadelphia and at Children’s Mercy Hospital in Kansas City), a central biochemistry laboratory (at the University of Rochester), and a data coordinating center (at Johns Hopkins School of Public Health) formed a cooperative agreement to conduct the CKiD Study.
Study Aims
- To determine risk factors for progression of pediatric chronic kidney disease
- To examine the impact of CKD on neurocognitive development
- To examine the impact of CKD on risk factors for cardiovascular disease
- To examine the impact of CKD on growth
Dr. Griffin Rodgers, Director of NIDDK gave the welcome talk, I didn’t get a chance to talk to him as he escaped during the first session.
Random fact:
While the prevalence of CKD in the US is 13%, the prevalence of ESRD is only 0.175%. Sadly, while CKD is progressive and would eventually lead everyone to ESRD, CVD mortalities often occur before CKD progresses through all of the stages
An example of funding and ancillary studies.
Tamara Isakova MD (Northwestern) started with a K23 ancillary -> K23/R01 -> R01 ASN funded her transition from K23 to R01, which is another ancillary study.
Example Studies:
- Equation for measurement of GFR
- APOL1 (apolipoprotein L1) associated glomerular disease, CKiD and NEPTUNE
- Disordered mineral metabolism in CKD
- Visceral adiposity and physical fitness in CKD
- Fibroblast growth factor 23 or FGF23
- Genetics of CAKUT
- Net Acid Excretion, Acid load and morbidity in CKD
- CVD in CKD
Regarding HD devices: I talked to Kevin Abbott (NIDDK) about the need for miniaturized HD machines. He thought the ICU would be a great place for smaller devices as many times, hospitals have had to expand to make room for the array of machines some patients need. Perhaps this is an area we can do more interviewing.
Ancillary study development (how to apply etc. mostly just go to the websites to see the process and to see what other studies have been done)
CKID
Go to website, concept sheet submitted to DCC (data something committee)
Proposal is reviewed.
Goes to steering committee- may need revision, until approval
(105 approved to date) most just want data, some want actual samples.
They approve, then we find funding. Duh.
https://statepi.jhsph.educkid/ivestigator.html
can call or e-mail with questions.
CRIC
Start process 3-4 moths before planed grant submission deadline.
Submit proposal to SDCC committee. Engage SDCC early.
In Summation:
It would behoove a research group investigating renal disease (CKD and ESRD) to take advantage of this data and use it to leverage funding. Even if the main goal of the group was RRT for ESRD, understanding CKD would be beneficial. I could see adding graduate students or postdocs to the team with this type of goal. I haven’t thought of any specific studies, but I’m sure we can think of something…