Relative risks of chronic kidney disease for mortality and end-stage renal disease across races are similar

Chi Pang Wen; Kunihiro Matsushita; Josef Coresh; Kunitoshi Iseki; Muhammad Islam; Ronit Katz; William McClellan; Carmen A. Peralta; Hai Yan Wang; Dick De Zeeuw; Brad C. Astor; Ron T. Gansevoort; Andrew S. Levey; Adeera Levin; Jackson T. Wright; Lawrence Appel; Tom Greene; John Chalmers; Stephen MacMahon; Mark Woodward; Hisatomi Arima; Hiroshi Yatsuya; Kentaro Yamashita; Hideaki Toyoshima; Koji Tamakoshi; Yingying Sang; Robert C. Atkins; Kevan R. Polkinghorne; Steven Chadban; Anoop Shankar; Ronald Klein; Barbara E.K. Klein; Kristine E. Lee; Fang Wang; Luxia Zhang; Li Zuo; Lisheng Liu; Ognjenka Djurdjev; Marcello Tonelli; Frank Sacks; Gary Curhan; Michael Shlipak; Linda Fried; Hiroyasu Iso; Akihiko Kitamura; Tetsuya Ohira; Kazumasa Yamagishi; Tazeen H. Jafar; Juanita Hatcher; Neil Poulter; Nish Chaturvedi; Martin J. Landray; Jonathan Emberson; Jonathan Townend; David C. Wheeler; Dietrich Rothenbacher; Hermann Brenner; Heiko Müller; Ben Schöttker; Caroline S. Fox; Shih Jen Hwang; James B. Meigs; Robert M. Perkins; Nick Fluck; Laura Clark; Gordon J. Prescott; Angharad Marks; Corri Black; Massimo Cirillo; Stein Hallan; Knut Aasard; Cecilia M. Øien; Marie Radtke; Fujiko Irie; Toshimi Sairenchi; David H. Smith; Jessica Weiss; Eric S. Johnson; Micah L. Thorp; Allan J. Collins; Joseph A. Vassalotti; Suying Li; Shu Cheng Chen; Brian J. Lee; Jack F. Wetzels; Peter J. Blankestijn; Arjan D. Van Zuilen; Mark Sarnak; Lesley Inker; Vandana Menon; Linda F. Fried; Holly Kramer; Ian De Boer; Florian Kronenberg; Barbara Kollerits; Eberhard Ritz; Paul Roderick; Dorothea Nitsch; Astrid Fletcher; Christopher Bulpitt; Areef Ishani; James Neaton; Marc Froissart; Benedicte Stengel; Marie Metzger; Jean Philippe Haymann; Pascal Houillier; Martin Flamant; Takayoshi Ohkubo; Hirohito Metoki; Masaaki Nakayama; Masahiro Kikuya; Yutaka Imai; Robert G. Nelson; William C. Knowler; Paul E. De Jong; Bakhtawar Khan Mahmoodi; Stephan J.L. Bakker; Simerjot Kaur Jassal; Elizabeth Barrett-Connor; Jaclyn Bergstrom; Hiddo J. Lambers Heerspink; Barry Brenner; David G. Warnock; Paul Muntner; Suzanne Judd; Sun Ha Jee; Heejin Kimm; Jaeseong Jo; Yejin Mok; Eunmi Choi; Peter Rossing; Hans Henrik Parving; Navdeep Tangri; David Naimark; Sung Feng Wen; Chwen Keng Tsao; Min Kuang Tsai; Shiuan Be Wu; Johan Ärnlöv; Lars Lannfelt; Anders Larsson; Henk J. Bilo; Hanneke Joosten; Nanne Kleefstra; Klaas H. Groenier; Iefke Drion; Brenda R. Hemmelgarn; Shoshana H. Ballew; Morgan Grams; Laura Camarata; Xuan Hui; Jennifer Seltzer; Heather Winegrad

doi:10.1038/ki.2013.553

Relative risks of chronic kidney disease for mortality and end-stage renal disease across races are similar

Chi Pang Wen, Kunihiro Matsushita, Josef Coresh, Kunitoshi Iseki, Muhammad Islam, Ronit Katz, William McClellan, Carmen A. Peralta, Hai Yan Wang, Dick De Zeeuw, Brad C. Astor, Ron T. Gansevoort, Andrew S. Levey, Adeera Levin, Jackson T. Wright, Lawrence Appel, Tom Greene, John Chalmers, Stephen MacMahon, Mark WoodwardHisatomi Arima, Hiroshi Yatsuya, Kentaro Yamashita, Hideaki Toyoshima, Koji Tamakoshi, Yingying Sang, Robert C. Atkins, Kevan R. Polkinghorne, Steven Chadban, Anoop Shankar, Ronald Klein, Barbara E.K. Klein, Kristine E. Lee, Fang Wang, Luxia Zhang, Li Zuo, Lisheng Liu, Ognjenka Djurdjev, Marcello Tonelli, Frank Sacks, Gary Curhan, Michael Shlipak, Linda Fried, Hiroyasu Iso, Akihiko Kitamura, Tetsuya Ohira, Kazumasa Yamagishi, Tazeen H. Jafar, Juanita Hatcher, Neil Poulter, Nish Chaturvedi, Martin J. Landray, Jonathan Emberson, Jonathan Townend, David C. Wheeler, Dietrich Rothenbacher, Hermann Brenner, Heiko Müller, Ben Schöttker, Caroline S. Fox, Shih Jen Hwang, James B. Meigs, Robert M. Perkins, Nick Fluck, Laura Clark, Gordon J. Prescott, Angharad Marks, Corri Black, Massimo Cirillo, Stein Hallan, Knut Aasard, Cecilia M. Øien, Marie Radtke, Fujiko Irie, Toshimi Sairenchi, David H. Smith, Jessica Weiss, Eric S. Johnson, Micah L. Thorp, Allan J. Collins, Joseph A. Vassalotti, Suying Li, Shu Cheng Chen, Brian J. Lee, Jack F. Wetzels, Peter J. Blankestijn, Arjan D. Van Zuilen, Mark Sarnak, Lesley Inker, Vandana Menon, Linda F. Fried, Holly Kramer, Ian De Boer, Florian Kronenberg, Barbara Kollerits, Eberhard Ritz, Paul Roderick, Dorothea Nitsch, Astrid Fletcher, Christopher Bulpitt, Areef Ishani, James Neaton, Marc Froissart, Benedicte Stengel, Marie Metzger, Jean Philippe Haymann, Pascal Houillier, Martin Flamant, Takayoshi Ohkubo, Hirohito Metoki, Masaaki Nakayama, Masahiro Kikuya, Yutaka Imai, Robert G. Nelson, William C. Knowler, Paul E. De Jong, Bakhtawar Khan Mahmoodi, Stephan J.L. Bakker, Simerjot Kaur Jassal, Elizabeth Barrett-Connor, Jaclyn Bergstrom, Hiddo J. Lambers Heerspink, Barry Brenner, David G. Warnock, Paul Muntner, Suzanne Judd, Sun Ha Jee, Heejin Kimm, Jaeseong Jo, Yejin Mok, Eunmi Choi, Peter Rossing, Hans Henrik Parving, Navdeep Tangri, David Naimark, Sung Feng Wen, Chwen Keng Tsao, Min Kuang Tsai, Shiuan Be Wu, Johan Ärnlöv, Lars Lannfelt, Anders Larsson, Henk J. Bilo, Hanneke Joosten, Nanne Kleefstra, Klaas H. Groenier, Iefke Drion, Brenda R. Hemmelgarn, Shoshana H. Ballew, Morgan Grams, Laura Camarata, Xuan Hui, Jennifer Seltzer, Heather Winegrad

Bloomberg School of Public Health

Research output: Contribution to journal › Article › peer-review

52 Scopus citations

Abstract

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.

Original language	English (US)
Pages (from-to)	819-827
Number of pages	9
Journal	Kidney international
Volume	86
Issue number	4
DOIs	https://doi.org/10.1038/ki.2013.553
State	Published - Jan 1 2014

Keywords

chronic kidney disease
end-stage renal disease
epidemiology and outcomes
ethnicity
mortality risk

ASJC Scopus subject areas

Nephrology

Access to Document

10.1038/ki.2013.553

Cite this

Wen, C. P., Matsushita, K., Coresh, J., Iseki, K., Islam, M., Katz, R., McClellan, W., Peralta, C. A., Wang, H. Y., De Zeeuw, D., Astor, B. C., Gansevoort, R. T., Levey, A. S., Levin, A., Wright, J. T., Appel, L., Greene, T., Chalmers, J., MacMahon, S., ... Winegrad, H. (2014). Relative risks of chronic kidney disease for mortality and end-stage renal disease across races are similar. Kidney international, 86(4), 819-827. https://doi.org/10.1038/ki.2013.553

Wen, CP, Matsushita, K, Coresh, J, Iseki, K, Islam, M, Katz, R, McClellan, W, Peralta, CA, Wang, HY, De Zeeuw, D, Astor, BC, Gansevoort, RT, Levey, AS, Levin, A, Wright, JT, Appel, L, Greene, T, Chalmers, J, MacMahon, S, Woodward, M, Arima, H, Yatsuya, H, Yamashita, K, Toyoshima, H, Tamakoshi, K, Sang, Y, Atkins, RC, Polkinghorne, KR, Chadban, S, Shankar, A, Klein, R, Klein, BEK, Lee, KE, Wang, F, Zhang, L, Zuo, L, Liu, L, Djurdjev, O, Tonelli, M, Sacks, F, Curhan, G, Shlipak, M, Fried, L, Iso, H, Kitamura, A, Ohira, T, Yamagishi, K, Jafar, TH, Hatcher, J, Poulter, N, Chaturvedi, N, Landray, MJ, Emberson, J, Townend, J, Wheeler, DC, Rothenbacher, D, Brenner, H, Müller, H, Schöttker, B, Fox, CS, Hwang, SJ, Meigs, JB, Perkins, RM, Fluck, N, Clark, L, Prescott, GJ, Marks, A, Black, C, Cirillo, M, Hallan, S, Aasard, K, Øien, CM, Radtke, M, Irie, F, Sairenchi, T, Smith, DH, Weiss, J, Johnson, ES, Thorp, ML, Collins, AJ, Vassalotti, JA, Li, S, Chen, SC, Lee, BJ, Wetzels, JF, Blankestijn, PJ, Van Zuilen, AD, Sarnak, M, Inker, L, Menon, V, Fried, LF, Kramer, H, De Boer, I, Kronenberg, F, Kollerits, B, Ritz, E, Roderick, P, Nitsch, D, Fletcher, A, Bulpitt, C, Ishani, A, Neaton, J, Froissart, M, Stengel, B, Metzger, M, Haymann, JP, Houillier, P, Flamant, M, Ohkubo, T, Metoki, H, Nakayama, M, Kikuya, M, Imai, Y, Nelson, RG, Knowler, WC, De Jong, PE, Mahmoodi, BK, Bakker, SJL, Jassal, SK, Barrett-Connor, E, Bergstrom, J, Lambers Heerspink, HJ, Brenner, B, Warnock, DG, Muntner, P, Judd, S, Jee, SH, Kimm, H, Jo, J, Mok, Y, Choi, E, Rossing, P, Parving, HH, Tangri, N, Naimark, D, Wen, SF, Tsao, CK, Tsai, MK, Wu, SB, Ärnlöv, J, Lannfelt, L, Larsson, A, Bilo, HJ, Joosten, H, Kleefstra, N, Groenier, KH, Drion, I, Hemmelgarn, BR, Ballew, SH, Grams, M , Camarata, L, Hui, X, Seltzer, J & Winegrad, H 2014, 'Relative risks of chronic kidney disease for mortality and end-stage renal disease across races are similar', Kidney international, vol. 86, no. 4, pp. 819-827. https://doi.org/10.1038/ki.2013.553

@article{f50cfc942dd84b139e5651f6d49d9140,

title = "Relative risks of chronic kidney disease for mortality and end-stage renal disease across races are similar",

abstract = "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.",

keywords = "chronic kidney disease, end-stage renal disease, epidemiology and outcomes, ethnicity, mortality risk",

author = "Wen, {Chi Pang} and Kunihiro Matsushita and Josef Coresh and Kunitoshi Iseki and Muhammad Islam and Ronit Katz and William McClellan and Peralta, {Carmen A.} and Wang, {Hai Yan} and {De Zeeuw}, Dick and Astor, {Brad C.} and Gansevoort, {Ron T.} and Levey, {Andrew S.} and Adeera Levin and Wright, {Jackson T.} and Lawrence Appel and Tom Greene and John Chalmers and Stephen MacMahon and Mark Woodward and Hisatomi Arima and Hiroshi Yatsuya and Kentaro Yamashita and Hideaki Toyoshima and Koji Tamakoshi and Yingying Sang and Atkins, {Robert C.} and Polkinghorne, {Kevan R.} and Steven Chadban and Anoop Shankar and Ronald Klein and Klein, {Barbara E.K.} and Lee, {Kristine E.} and Fang Wang and Luxia Zhang and Li Zuo and Lisheng Liu and Ognjenka Djurdjev and Marcello Tonelli and Frank Sacks and Gary Curhan and Michael Shlipak and Linda Fried and Hiroyasu Iso and Akihiko Kitamura and Tetsuya Ohira and Kazumasa Yamagishi and Jafar, {Tazeen H.} and Juanita Hatcher and Neil Poulter and Nish Chaturvedi and Landray, {Martin J.} and Jonathan Emberson and Jonathan Townend and Wheeler, {David C.} and Dietrich Rothenbacher and Hermann Brenner and Heiko M{\"u}ller and Ben Sch{\"o}ttker and Fox, {Caroline S.} and Hwang, {Shih Jen} and Meigs, {James B.} and Perkins, {Robert M.} and Nick Fluck and Laura Clark and Prescott, {Gordon J.} and Angharad Marks and Corri Black and Massimo Cirillo and Stein Hallan and Knut Aasard and {\O}ien, {Cecilia M.} and Marie Radtke and Fujiko Irie and Toshimi Sairenchi and Smith, {David H.} and Jessica Weiss and Johnson, {Eric S.} and Thorp, {Micah L.} and Collins, {Allan J.} and Vassalotti, {Joseph A.} and Suying Li and Chen, {Shu Cheng} and Lee, {Brian J.} and Wetzels, {Jack F.} and Blankestijn, {Peter J.} and {Van Zuilen}, {Arjan D.} and Mark Sarnak and Lesley Inker and Vandana Menon and Fried, {Linda F.} and Holly Kramer and {De Boer}, Ian and Florian Kronenberg and Barbara Kollerits and Eberhard Ritz and Paul Roderick and Dorothea Nitsch and Astrid Fletcher and Christopher Bulpitt and Areef Ishani and James Neaton and Marc Froissart and Benedicte Stengel and Marie Metzger and Haymann, {Jean Philippe} and Pascal Houillier and Martin Flamant and Takayoshi Ohkubo and Hirohito Metoki and Masaaki Nakayama and Masahiro Kikuya and Yutaka Imai and Nelson, {Robert G.} and Knowler, {William C.} and {De Jong}, {Paul E.} and Mahmoodi, {Bakhtawar Khan} and Bakker, {Stephan J.L.} and Jassal, {Simerjot Kaur} and Elizabeth Barrett-Connor and Jaclyn Bergstrom and {Lambers Heerspink}, {Hiddo J.} and Barry Brenner and Warnock, {David G.} and Paul Muntner and Suzanne Judd and Jee, {Sun Ha} and Heejin Kimm and Jaeseong Jo and Yejin Mok and Eunmi Choi and Peter Rossing and Parving, {Hans Henrik} and Navdeep Tangri and David Naimark and Wen, {Sung Feng} and Tsao, {Chwen Keng} and Tsai, {Min Kuang} and Wu, {Shiuan Be} and Johan {\"A}rnl{\"o}v and Lars Lannfelt and Anders Larsson and Bilo, {Henk J.} and Hanneke Joosten and Nanne Kleefstra and Groenier, {Klaas H.} and Iefke Drion and Hemmelgarn, {Brenda R.} and Ballew, {Shoshana H.} and Morgan Grams and Laura Camarata and Xuan Hui and Jennifer Seltzer and Heather Winegrad",

note = "Funding Information: The CKD-PC Data Coordinating Center is funded in part by a program grant from the US National Kidney Foundation (NKF funding sources include Abbott) and an investigator-initiated research grant from Amgen. A variety of sources have supported enrollment and data collection, including laboratory measurements and follow-up in the collaborating cohorts of the CKD-PC. These funding sources include government agencies such as national institutes of health and medical research councils, as well as foundations and industry sponsors listed in Supplementary Appendix 3 online. The funders had no role in the design, analysis, interpretation of this study, and did not contribute to the writing of this report and the decision to submit the article for publication. The sponsors had no role in the design and conduct of the study; in the collection, analysis, and interpretation of the data, or in the preparation, review, or approval of the manuscript. A variation of this analysis was presented at the American Society of Nephrology Kidney Week 2012 (San Diego, CA, 3 November 2012). ",

year = "2014",

month = jan,

day = "1",

doi = "10.1038/ki.2013.553",

language = "English (US)",

volume = "86",

pages = "819--827",

journal = "Kidney international",

issn = "0085-2538",

publisher = "Nature Publishing Group",

number = "4",

}

TY - JOUR

T1 - Relative risks of chronic kidney disease for mortality and end-stage renal disease across races are similar

AU - Wen, Chi Pang

AU - Matsushita, Kunihiro

AU - Coresh, Josef

AU - Iseki, Kunitoshi

AU - Islam, Muhammad

AU - Katz, Ronit

AU - McClellan, William

AU - Peralta, Carmen A.

AU - Wang, Hai Yan

AU - De Zeeuw, Dick

AU - Astor, Brad C.

AU - Gansevoort, Ron T.

AU - Levey, Andrew S.

AU - Levin, Adeera

AU - Wright, Jackson T.

AU - Appel, Lawrence

AU - Greene, Tom

AU - Chalmers, John

AU - MacMahon, Stephen

AU - Woodward, Mark

AU - Arima, Hisatomi

AU - Yatsuya, Hiroshi

AU - Yamashita, Kentaro

AU - Toyoshima, Hideaki

AU - Tamakoshi, Koji

AU - Sang, Yingying

AU - Atkins, Robert C.

AU - Polkinghorne, Kevan R.

AU - Chadban, Steven

AU - Shankar, Anoop

AU - Klein, Ronald

AU - Klein, Barbara E.K.

AU - Lee, Kristine E.

AU - Wang, Fang

AU - Zhang, Luxia

AU - Zuo, Li

AU - Liu, Lisheng

AU - Djurdjev, Ognjenka

AU - Tonelli, Marcello

AU - Sacks, Frank

AU - Curhan, Gary

AU - Shlipak, Michael

AU - Fried, Linda

AU - Iso, Hiroyasu

AU - Kitamura, Akihiko

AU - Ohira, Tetsuya

AU - Yamagishi, Kazumasa

AU - Jafar, Tazeen H.

AU - Hatcher, Juanita

AU - Poulter, Neil

AU - Chaturvedi, Nish

AU - Landray, Martin J.

AU - Emberson, Jonathan

AU - Townend, Jonathan

AU - Wheeler, David C.

AU - Rothenbacher, Dietrich

AU - Brenner, Hermann

AU - Müller, Heiko

AU - Schöttker, Ben

AU - Fox, Caroline S.

AU - Hwang, Shih Jen

AU - Meigs, James B.

AU - Perkins, Robert M.

AU - Fluck, Nick

AU - Clark, Laura

AU - Prescott, Gordon J.

AU - Marks, Angharad

AU - Black, Corri

AU - Cirillo, Massimo

AU - Hallan, Stein

AU - Aasard, Knut

AU - Øien, Cecilia M.

AU - Radtke, Marie

AU - Irie, Fujiko

AU - Sairenchi, Toshimi

AU - Smith, David H.

AU - Weiss, Jessica

AU - Johnson, Eric S.

AU - Thorp, Micah L.

AU - Collins, Allan J.

AU - Vassalotti, Joseph A.

AU - Li, Suying

AU - Chen, Shu Cheng

AU - Lee, Brian J.

AU - Wetzels, Jack F.

AU - Blankestijn, Peter J.

AU - Van Zuilen, Arjan D.

AU - Sarnak, Mark

AU - Inker, Lesley

AU - Menon, Vandana

AU - Fried, Linda F.

AU - Kramer, Holly

AU - De Boer, Ian

AU - Kronenberg, Florian

AU - Kollerits, Barbara

AU - Ritz, Eberhard

AU - Roderick, Paul

AU - Nitsch, Dorothea

AU - Fletcher, Astrid

AU - Bulpitt, Christopher

AU - Ishani, Areef

AU - Neaton, James

AU - Froissart, Marc

AU - Stengel, Benedicte

AU - Metzger, Marie

AU - Haymann, Jean Philippe

AU - Houillier, Pascal

AU - Flamant, Martin

AU - Ohkubo, Takayoshi

AU - Metoki, Hirohito

AU - Nakayama, Masaaki

AU - Kikuya, Masahiro

AU - Imai, Yutaka

AU - Nelson, Robert G.

AU - Knowler, William C.

AU - De Jong, Paul E.

AU - Mahmoodi, Bakhtawar Khan

AU - Bakker, Stephan J.L.

AU - Jassal, Simerjot Kaur

AU - Barrett-Connor, Elizabeth

AU - Bergstrom, Jaclyn

AU - Lambers Heerspink, Hiddo J.

AU - Brenner, Barry

AU - Warnock, David G.

AU - Muntner, Paul

AU - Judd, Suzanne

AU - Jee, Sun Ha

AU - Kimm, Heejin

AU - Jo, Jaeseong

AU - Mok, Yejin

AU - Choi, Eunmi

AU - Rossing, Peter

AU - Parving, Hans Henrik

AU - Tangri, Navdeep

AU - Naimark, David

AU - Wen, Sung Feng

AU - Tsao, Chwen Keng

AU - Tsai, Min Kuang

AU - Wu, Shiuan Be

AU - Ärnlöv, Johan

AU - Lannfelt, Lars

AU - Larsson, Anders

AU - Bilo, Henk J.

AU - Joosten, Hanneke

AU - Kleefstra, Nanne

AU - Groenier, Klaas H.

AU - Drion, Iefke

AU - Hemmelgarn, Brenda R.

AU - Ballew, Shoshana H.

AU - Grams, Morgan

AU - Camarata, Laura

AU - Hui, Xuan

AU - Seltzer, Jennifer

AU - Winegrad, Heather

N1 - Funding Information: The CKD-PC Data Coordinating Center is funded in part by a program grant from the US National Kidney Foundation (NKF funding sources include Abbott) and an investigator-initiated research grant from Amgen. A variety of sources have supported enrollment and data collection, including laboratory measurements and follow-up in the collaborating cohorts of the CKD-PC. These funding sources include government agencies such as national institutes of health and medical research councils, as well as foundations and industry sponsors listed in Supplementary Appendix 3 online. The funders had no role in the design, analysis, interpretation of this study, and did not contribute to the writing of this report and the decision to submit the article for publication. The sponsors had no role in the design and conduct of the study; in the collection, analysis, and interpretation of the data, or in the preparation, review, or approval of the manuscript. A variation of this analysis was presented at the American Society of Nephrology Kidney Week 2012 (San Diego, CA, 3 November 2012).

PY - 2014/1/1

Y1 - 2014/1/1

N2 - 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.

AB - 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.

KW - chronic kidney disease

KW - end-stage renal disease

KW - epidemiology and outcomes

KW - ethnicity

KW - mortality risk

UR - http://www.scopus.com/inward/record.url?scp=84926175702&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84926175702&partnerID=8YFLogxK

U2 - 10.1038/ki.2013.553

DO - 10.1038/ki.2013.553

M3 - Article

C2 - 24522492

AN - SCOPUS:84926175702

SN - 0085-2538

VL - 86

SP - 819

EP - 827

JO - Kidney international

JF - Kidney international

IS - 4

ER -

Relative risks of chronic kidney disease for mortality and end-stage renal disease across races are similar

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