Chronic kidney disease (CKD) affects up to 16% of the adult population and is associated with significant morbidity and mortality. People at highest risk from progressive CKD are defined by a sustained decline in estimated glomerular filtration rate (eGFR) and/or the presence of significant albuminuria/proteinuria. Accurate mapping of the bio-clinical determinants of this group will enable improved risk stratification and direct the development of better targeted management for people with CKD. To address these requirements we have established the Renal Impairment in Secondary Care (RIISC) study; RIISC is enrolling a cohort of patients at high risk from progressive CKD and compiling a comprehensive and detailed bio-clinical phenotype, including vascular and oral health phenotyping, at enrolment and on subsequent follow-up.

Inclusion Criteria:

• Decline of eGFR of ≥5mls/min/year or ≥10mls/min/5years
• and/or urinary albumin-creatinine ration (ACR) ≥70 mg/mmol on three occasions
• and/or CKD 4 or 5 (pre-dialysis)

Exclusion Criteria:

• renal replacement therapy
• immunosuppression

Secondary care kidney disease clinics

Anonymised patient data is being shared within the remit of the ethics for this study with collaborators