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Kidney Int. 2014 Oct;86(4):819-27. doi: 10.1038/ki.2013.553. Epub 2014 Feb 12.

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

Collaborators (178)

Wright JT Jr, Appel L, Greene T, Astor BC, Chalmers J, MacMahon S, Woodward M, Arima H, Yatsuya H, Yamashita K, Toyoshima H, Tamakoshi K, Coresh J, Astor BC, Matsushita K, Atkins RC, Polkinghorne KR, Chadban S, Shankar A, Klein R, Klein BE, Lee KE, Wang H, Wang F, Zhang L, Zuo L, Liu L, Levin A, Djurdjev O, Tonelli M, Sacks F, Curhan G, Shlipak M, Peralta C, Katz R, Fried L, Iso H, Kitamura A, Ohira T, Yamagishi K, Jafar TH, Islam M, 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, Iso H, Sairenchi T, Yamagishi K, 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, Levey AS, Inker L, Menon V, Shlipak M, Sarnak M, Peralta C, Katz R, 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, Astor BC, Coresh J, Matsushita K, Ohkubo T, Metoki H, Nakayama M, Kikuya M, Imai Y, Iseki K, Nelson RG, Knowler WC, Gansevoort RT, de Jong PE, Mahmoodi BK, Bakker SJ, Bernardo R, Kaur Jassal S, Barrett-Connor E, Bergstrom J, Heerspink HJ, Brenner B, de Zeeuw D, Warnock DG, Muntner P, Judd S, McClellan W, Jee SH, Kimm H, Jo J, Mok Y, Choi E, Rossing P, Parving HH, Tangri N, Naimark D, Wen CP, Wen SF, Tsao CK, Tsai MK, Be Wu S, Ärnlöv J, Lannfelt L, Larsson A, Bilo HJ, Joosten H, Kleefstra N, Groenier KH, Drion I, Astor BC, Coresh J, Gansevoort RT, Hemmelgarn BR, de Jong PE, Levey AS, Levin A, Matsushita K, Wen CP, Woodward M, Ballew SH, Coresh J, Grams M, Mahmoodi BK, Matsushita K, Sang Y, Woodward M, Camarata L, Hui X, Seltzer J, Winegrad H.

Author information

1
1] Institute of Population Science, National Health Research Institutes, Zhunan, Taiwan [2] China Medical University Hospital, Taichung, Taiwan.
2
Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA.
3
Dialysis Unit, University Hospital of The Ryukyus, Nishihara, Japan.
4
Department of Community Health Sciences, The Aga Khan University, Karachi, Pakistan.
5
Kidney Research Institute, University of Washington, Seattle, Washington, USA.
6
Department of Medicine, Emory University School of Medicine, Atlanta, Georgia, USA.
7
Division of Nephrology, University of California, San Francisco, California, USA.
8
Renal Division, Department of Medicine, Peking University First Hospital, Institute of Nephrology, Peking University, Key Laboratory of Renal Disease, Ministry of Health of China, Beijing, China.
9
Department of Clinical Pharmacology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.
10
1] Department of Medicine, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, USA [2] Department of Population Health Sciences, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, USA.
11
Department of Nephrology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.
12
Division of Nephrology, Tufts Medical Center, Boston, Massachusetts, USA.
13
Division of Nephrology UBC, St Pauls Hospital, Vancouver, British Columbia, Canada.

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.

PMID:
24522492
PMCID:
PMC4048178
DOI:
10.1038/ki.2013.553
[Indexed for MEDLINE]
Free PMC Article

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