Title | Relative risks of chronic kidney disease for mortality and end-stage renal disease across races are similar. |
Publication Type | Journal Article |
Year of Publication | 2014 |
Authors | Wen, CPang, Matsushita, K, Coresh, J, Iseki, K, Islam, M, Katz, R, McClellan, W, Peralta, CA, Wang, H, de Zeeuw, D, Astor, BC, Gansevoort, RT, Levey, AS, Levin, A |
Corporate/Institutional Authors | Chronic Kidney Disease Prognosis Consortium, |
Journal | Kidney Int |
Volume | 86 |
Issue | 4 |
Pagination | 819-27 |
Date Published | 2014 Oct |
ISSN | 1523-1755 |
Keywords | Adult, African Continental Ancestry Group, Aged, Aged, 80 and over, Albuminuria, Asian Continental Ancestry Group, Cardiovascular Diseases, Cohort Studies, Creatinine, European Continental Ancestry Group, Female, Glomerular Filtration Rate, Humans, Kidney Failure, Chronic, Male, Middle Aged, Odds Ratio, Renal Insufficiency, Chronic, Risk Factors |
Abstract | <p>Some suggest race-specific cutpoints for kidney measures to define and stage chronic kidney disease (CKD), but evidence for race-specific clinical impact is limited. To address this issue, we compared hazard ratios of estimated glomerular filtration rates (eGFR) and albuminuria across races using meta-regression in 1.1 million adults (75% Asians, 21% Whites, and 4% Blacks) from 45 cohorts. Results came mainly from 25 general population cohorts comprising 0.9 million individuals. The associations of lower eGFR and higher albuminuria with mortality and end-stage renal disease (ESRD) were largely similar across races. For example, in Asians, Whites, and Blacks, the adjusted hazard ratios (95% confidence interval) for eGFR 45-59 versus 90-104 ml/min per 1.73 m(2) were 1.3 (1.2-1.3), 1.1 (1.0-1.2), and 1.3 (1.1-1.7) for all-cause mortality, 1.6 (1.5-1.7), 1.4 (1.2-1.7), and 1.4 (0.7-2.9) for cardiovascular mortality, and 27.6 (11.1-68.7), 11.2 (6.0-20.9), and 4.1 (2.2-7.5) for ESRD, respectively. The corresponding hazard ratios for urine albumin-to-creatinine ratio 30-299 mg/g or dipstick 1+ versus an albumin-to-creatinine ratio under 10 or dipstick negative were 1.6 (1.4-1.8), 1.7 (1.5-1.9), and 1.8 (1.7-2.1) for all-cause mortality, 1.7 (1.4-2.0), 1.8 (1.5-2.1), and 2.8 (2.2-3.6) for cardiovascular mortality, and 7.4 (2.0-27.6), 4.0 (2.8-5.9), and 5.6 (3.4-9.2) for ESRD, respectively. Thus, the relative mortality or ESRD risks of lower eGFR and higher albuminuria were largely similar among three major races, supporting similar clinical approach to CKD definition and staging, across races. </p> |
DOI | 10.1038/ki.2013.553 |
Alternate Journal | Kidney Int. |
PubMed ID | 24522492 |
PubMed Central ID | PMC4048178 |
Grant List | HHSN268201100012C / HL / NHLBI NIH HHS / United States K23 DK067303 / DK / NIDDK NIH HHS / United States N01 HC085086 / HC / NHLBI NIH HHS / United States U01 DK035073 / DK / NIDDK NIH HHS / United States HHSN268201100010C / HL / NHLBI NIH HHS / United States R01 AG015928 / AG / NIA NIH HHS / United States HHSN268201100008C / HL / NHLBI NIH HHS / United States UL1 TR001079 / TR / NCATS NIH HHS / United States N01 HC075150 / HC / NHLBI NIH HHS / United States K23 DK002904 / DK / NIDDK NIH HHS / United States U10 EY006594 / EY / NEI NIH HHS / United States HHSN268201100007C / HL / NHLBI NIH HHS / United States N01 HC015103 / HC / NHLBI NIH HHS / United States N01 HC025195 / HC / NHLBI NIH HHS / United States HHSN268201100011C / HL / NHLBI NIH HHS / United States N01HC55222 / HL / NHLBI NIH HHS / United States R01 AG007181 / AG / NIA NIH HHS / United States R01 DK073217 / DK / NIDDK NIH HHS / United States HHSN268201100006C / HL / NHLBI NIH HHS / United States PG/02/153/14616 / / British Heart Foundation / United Kingdom HHSN268201200036C / HL / NHLBI NIH HHS / United States R01 DK031801 / DK / NIDDK NIH HHS / United States 070854 / / Wellcome Trust / United Kingdom U01 NS041588 / NS / NINDS NIH HHS / United States N01 HC095169 / HC / NHLBI NIH HHS / United States R01 HL080295 / HL / NHLBI NIH HHS / United States R01 AG020098 / AG / NIA NIH HHS / United States HHSN268201100009C / HL / NHLBI NIH HHS / United States HHSN268201100005C / HL / NHLBI NIH HHS / United States N01 HC085079 / HC / NHLBI NIH HHS / United States R01 HL068140 / HL / NHLBI NIH HHS / United States R01 AG023629 / AG / NIA NIH HHS / United States R01 AG028507 / AG / NIA NIH HHS / United States R01 AG027058 / AG / NIA NIH HHS / United States N01 HC045133 / HC / NHLBI NIH HHS / United States N01 HC035129 / HC / NHLBI NIH HHS / United States CZH/4/656 / / Chief Scientist Office / United Kingdom R01 HL043232-03 / HL / NHLBI NIH HHS / United States N01 HC095159 / HC / NHLBI NIH HHS / United States |