American Indian Chronic Renal Insufficiency Cohort Study (AI-CRIC Study)

Investigators will conduct a longitudinal study of a CKD cohort of Southwest AIs to identify unique risk factors for CKD and CVD progression and compare CKD and CVD event rates and risk factors between AI and the populations represented in CRIC. Investigators will establish a specimen bank to support future ancillary studies designed to identify and examine biomarkers associated with the progression of CKD in AIs.

At the Clinic Visit the following will occur:

• weight is measured
• blood pressure and heart rate are recorded
• information about medical history and medication used recently
• blood draw (about ½ cup) for the following tests: CBC (Complete Blood Count), tests of metabolism, and several other heart and kidney tests
• blood pressure in the leg and arm calculated as the Ankle Brachial Index (ABI)
• urine sample collection for kidney function testing
• complete questionnaires about quality of life, diet, mood, thought processes and physical activity.

This visit takes about 1 to 2 hours. Participants will be contacted by telephone six months after the Baseline Visit to ask about recent medical events and medications.

Participants will be asked to return to the center for annual visits during which many but not all of the procedures described above will be conducted.

Additionally, participants will be asked to participate in one of two substudies using remote data collection techniques to identify trajectories of kidney function and cardiovascular risk sub-phenotypes

Inclusion criteria

• Glomerular Filtration Rate (GFR): eGFR of =>61<80 and microalbuminuria > 30 or eGRF of =<60 (no microalbuminuria required).

Exclusion criteria

• Unable or unwilling to provide informed consent
• life expectancy <3 years;
• institutionalized subjects;
• End stage renal disease or renal transplant;
• renal cancer;
• myeloma;
• immunosuppression;
• Polycystic kidney disease;
• participation in any clinical trial,
• current pregnancy
• current incarceration.
• Appears unlikely or unable to participate in the required study procedures as assessed by the investigator, study coordinator or designee.