Using electronic health records to improve cardiovascular-kidney-metabolic health: a protocol for the China Cardiovascular-Kidney-Metabolic Cohort-WeinAn REsearch (CKM-CARE).

INTRODUCTION: The ageing population faces a growing burden of poor cardiovascular-kidney-metabolic (CKM) health, which is receiving increasing attention globally. The proposed China Cardiovascular-Kidney-Metabolic Cohort-Weinan Research (CKM-CARE) aims to establish a regional surveillance system in an underdeveloped city in northwest China to collect comprehensive and dynamic data on the CKM prevalence and progression in Chinese population, to inform better CKM care and effective intervention strategies. METHODS AND ANALYSIS: The CKM-CARE study will leverage individual-level data from the regional electronic health record (EHR) system of Weinan City, Shaanxi Province, to establish an ambispective longitudinal cohort for CKM care and outcomes research. Between January 2020 and November 2024, 551 736 valid adult participants registered in the Weinan EHR system were included in CKM-CARE, with 442 299 individuals (80.2%) identified as having CKM stages 1-4. The study will integrate data from multiple sources, including administrative, clinical, laboratory, pharmaceutical, inpatient and outpatient electronic medical records (EMRs), and chronic disease management databases. Follow-up for CKM disease progression and related adverse clinical events will be conducted until December 2029 through linkage with the regional systems for death surveillance, chronic disease management and EMRs. The CKM-CARE study will provide a valuable big data resource to support data-driven CKM health management and policymaking in China. ETHICS AND DISSEMINATION: The CKM-CARE study has been reviewed and approved by the ethics committee of Peking University First Hospital (number: 2024 R480-001) and the local health authority. The privacy and confidentiality of residents registered in the regional health information system will be strictly protected throughout the study process. Study findings will be disseminated through peer-reviewed journal publications, conferences and seminar presentations.