Renal Insufficiency, Chronic Clinical Trial
Official title:
Chronic Kidney Disease - Renal Epidemiology and Information Network: The CKD-REIN Cohort
Preserving kidney function and improving the transition from CKD to End stage renal disease
(ESRD) is a research and healthcare challenge. The Chronic Kidney Disease-Renal Epidemiology
and Information Network (CKD-REIN) cohort was established to identify the determinants,
biomarkers and practice patterns associated with chronic kidney disease outcomes. The study
includes 3,033 adult patients with moderate to advanced CKD from a representative sample of
40 nephrology clinics in France with respect to regions and legal status. Patients are
recruited during a routine visit and followed up for 5 years, before and after starting renal
replacement therapy. Patient-level clinical, biological, and lifestyle data are collected
annually, as well as provider-level data on clinical practices, coordinated with the
International Chronic Kidney Disease Outcomes and Practice Pattern Study (CKDopps). Blood and
urine samples are stored in a biobank. The overall objective is to develop a research
platform to address key questions regarding the determinants and biomarkers associated with
adverse outcomes in CKD and to assess its effective management. It has the following
hypotheses and specific aims:
1. to evaluate a large set of social, environmental, bioclinical, and genetic factors, and
their interactions in relation with CKD outcomes including progression to ESRD,
mortality, metabolic and vascular complications, and the onset of a number of chronic
and acute events;
2. to assess several new biomarkers to predict adverse outcomes of CKD and its
complications;
3. to evaluate the associations of provider practices (management of hypertension, anemia,
nutritional abnormalities, mineral and bone disorder, nutritional status, timing of
dialysis initiation and transplant wait-listing) with achievement of clinical practice
guidelines, clinical and patient-reported outcomes (PRO).
4. to evaluate the associations of health care organization and clinic services (e.g., for
nutrition, educational programs) with clinical and patient-reported outcomes, and
achievement of clinical practice guidelines;
5. to estimate the relative cost-effectiveness of different provider practices and clinic
services.
All cohort participants are assessed annually for at least 5 years, until 6 months after the
start of renal replacement therapy.
Each year, data are collected from both medical records and patients interview and
self-administrated questionnaires are asked to report clinical events.
Interviews and routine biological measurements are repeated annually.
CKD-REIN is funded by the Agence Nationale de la Recherche through the 2010
'Cohortes-Investissements d'Avenir' programme and by the 2010 national Programme Hospitalier
de Recherche Clinique.
CKD-REIN is also supported through a public-private partnership with Amgen, Fresenius Medical
Care, and GlaxoSmithKline since 2012; Baxter and MerckSharp&Dohme-Chibret (France) from 2012
to 2017; LillyFrance since 2013; Otsuka Pharmaceutical since 2015; Vifor Fresenius since
2017; AstraZeneca since 2018; and Sanofi-Genzyme from 2012 to 2015.
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