1. Rationale and population-based prospective cohort protocol for the disadvantaged populations at risk of decline in eGFR (CO-DEGREE)
- Author
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Gonzalez-Quiroz, M, Nitsch, D, Hamilton, S, O'Callaghan Gordo, C, Saran, R, Glaser, J, Correa-Rotter, R, Jakobsson, K, Singh, A, Gunawardena, N, Levin, A, Remuzzi, G, Caplin, B, Pearce, N, Bernabe-Ortiz, A, Burdmann, E, Jha, V, Johnson, R, Kaur, P, Kongtip, P, Kromhout, H, Madero Rovalo, M, Nyirenda, M, Perel, P, Prabhkaran, D, Prasad, N, Smeeth, L, and Venugopal, V
- Subjects
CHRONIC KIDNEY-DISEASE ,Male ,Rural Population ,Epidemiology ,International Cooperation ,030232 urology & nephrology ,030204 cardiovascular system & hematology ,Cohort Studies ,0302 clinical medicine ,DEGREE Study Steering Committee ,Clinical Protocols ,Informed consent ,Risk Factors ,Prevalence ,Protocol ,Prospective cohort study ,education.field_of_study ,ORIGIN ,Incidence (epidemiology) ,WORKERS ,General Medicine ,3. Good health ,Proteinuria ,Research Design ,Cohort ,Disease Progression ,CENTRAL-AMERICA ,EL SALVADOR ,Female ,Life Sciences & Biomedicine ,Cohort study ,Glomerular Filtration Rate ,UNKNOWN ETIOLOGY ,medicine.medical_specialty ,Population ,Renal function ,Risk Assessment ,REGION ,1117 Public Health and Health Services ,03 medical and health sciences ,Young Adult ,Medicine, General & Internal ,EPIDEMIC ,General & Internal Medicine ,medicine ,decline in kidney function ,Humans ,Renal Insufficiency, Chronic ,education ,Health Services Needs and Demand ,prospective cohort study ,Science & Technology ,business.industry ,1103 Clinical Sciences ,CHRONIC INTERSTITIAL NEPHRITIS ,medicine.disease ,Emergency medicine ,Kidney Failure, Chronic ,chronic kidney disease of unknown aetiology ,business ,1199 Other Medical and Health Sciences ,Kidney disease ,generic cohort protocol - Abstract
IntroductionA recently recognised form of chronic kidney disease (CKD) of unknown origin (CKDu) is afflicting communities, mostly in rural areas in several regions of the world. Prevalence studies are being conducted in a number of countries, using a standardised protocol, to estimate the distribution of estimated glomerular filtration rate (eGFR), and thus identify communities with a high prevalence of reduced glomerular filtration rate (GFR). In this paper, we propose a standardised minimum protocol for cohort studies in high-risk communities aimed at investigating the incidence of, and risk factors for, early kidney dysfunction.Methods and analysisThis generic cohort protocol provides the information to establish a prospective population-based cohort study in low-income settings with a high prevalence of CKDu. This involves a baseline survey that included key elements from the DEGREE survey (eg, using the previously published DEGREE methodology) of a population-representative sample, and subsequent follow-up visits in young adults (without a pre-existing diagnosis of CKD (eGFR2), proteinuria or risk factors for CKD at baseline) over several years. Each visit involves a core questionnaire, and collection and storage of biological samples. Local capacity to measure serum creatinine will be required so that immediate feedback on kidney function can be provided to participants. After completion of follow-up, repeat measures of creatinine should be conducted in a central laboratory, using reference standards traceable to isotope dilution mass spectrometry (IDMS) quality control material to quantify the main outcome of eGFR decline over time, alongside a description of the early evolution of disease and risk factors for eGFR decline.Ethics and disseminationEthical approval will be obtained by local researchers, and participants will provide informed consent before the study commences. Participants will typically receive feedback and advice on their laboratory results, and referral to a local health system where appropriate.
- Published
- 2019