Relative risks of chronic kidney disease for mortality and end-stage renal disease across races are similar
Author(s)
Type
Journal Article
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.
Date Issued
2014-10-01
Date Acceptance
2013-11-21
Citation
Kidney International, 2014, 86 (4), pp.819-827
ISSN
0085-2538
Publisher
Elsevier
Start Page
819
End Page
827
Journal / Book Title
Kidney International
Volume
86
Issue
4
Copyright Statement
Copyright © 2014 International Society of Nephrology. Published by Elsevier Inc. All rights reserved. . This manuscript is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International Licence http://creativecommons.org/licenses/by-nc-nd/4.0/
Identifier
https://www.ncbi.nlm.nih.gov/pubmed/24522492
PII: S0085-2538(15)30365-3
Subjects
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
Publication Status
Published
Coverage Spatial
United States
Date Publish Online
2014-02-12