title: Design and implementation of the Canadian Kidney Disease Cohort Study (CKDCS): A prospective observational study of incident hemodialysis patients.
abstract: BACKGROUND
  Many nephrology observational studies use renal registries, which have well known limitations. The Canadian Kidney Disease Cohort Study (CKDCS) is a large prospective observational study of patients commencing hemodialysis in five Canadian centers. This study focuses on delineating potentially reversible determinants of adverse outcomes that occur in patients receiving dialysis for end-stage renal disease (ESRD).
  
  
  METHODS
  The CKDCS collects information on risk factors and outcomes, and stores specimens (blood, dialysate, hair and fingernails) at baseline and in long-term follow-up. Such specimens will permit measurements of biochemical markers, proteomic and genetic parameters (proteins and DNA) not measured in routine care. To avoid selection bias, all consenting incident hemodialysis patients at participating centers are enrolled, the large sample size (target of 1500 patients), large number of exposures, and high event rates will permit the exploration of multiple potential research questions.
  
  
  RESULTS
  Data on the baseline characteristics from the first 1074 subjects showed that the average age of patients was 62 (range; 50-73) years. The leading cause of ESRD was diabetic nephropathy (41.9%), and the majority of the patients were white (80.0%). Only 18.7% of the subjects received dialysis in a satellite unit, and over 80% lived within a 50 km radius of the nearest nephrologist's practice.
  
  
  CONCLUSIONS
  The prospective design, detailed clinical information, and stored biological specimens provide a wealth of information with potential to greatly enhance our understanding of risk factors for adverse outcomes in dialysis patients. The scientific value of the stored patient tissue will grow as new genetic and biochemical markers are discovered in the future.
authors.affiliation: Department of Medicine, University of Alberta, Edmonton, Canada.
authors.forename: Aminu K
authors.initials: AK
authors.lastname: Bello
authors.forename: Ravi
authors.initials: R
authors.lastname: Thadhani
authors.forename: Brenda
authors.initials: B
authors.lastname: Hemmelgarn
authors.forename: Scott
authors.initials: S
authors.lastname: Klarenbach
authors.forename: John
authors.initials: J
authors.lastname: Gill
authors.forename: Christopher
authors.initials: C
authors.lastname: Chan
authors.forename: Deborah
authors.initials: D
authors.lastname: Zimmerman
authors.forename: Daniel
authors.initials: D
authors.lastname: Holmes
authors.forename: George
authors.initials: G
authors.lastname: Cembrowski
authors.forename: Dawn
authors.initials: D
authors.lastname: Opgenorth
authors.forename: Rafael
authors.initials: R
authors.lastname: Sibrian
authors.forename: Mohammad
authors.initials: M
authors.lastname: Karkhaneh
authors.forename: Sophanny
authors.initials: S
authors.lastname: Tiv
authors.forename: Natasha
authors.initials: N
authors.lastname: Wiebe
authors.forename: Marcello
authors.initials: M
authors.lastname: Tonelli
mesh_terms: D000368:Aged; D002170:Canada; D016208:Databases, Factual; D005260:Female; D006801:Humans; D007676:Kidney Failure, Chronic / Q000150:complications / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D019370:Observation; D011446:Prospective Studies; D006435:Renal Dialysis / Q000009:adverse effects*; D012107:Research Design