CKD and Cardiovascular Disease in the Atherosclerosis Risk in Communities (ARIC) Study: Interactions With Age, Sex, and Race

Background Estimated glomerular filtration rate (eGFR) and albuminuria are central for diagnosis, staging, and risk evaluation in chronic kidney disease (CKD). Universal thresholds regardless of age, sex, and race are recommended, but relatively little is known about how these demographic factors alter the relationship of eGFR and albuminuria to cardiovascular outcomes. Study Design Observational cohort study. Setting & Participants 11,060 whites and blacks aged 52-75 years in the Atherosclerosis Risk in Communities (ARIC) Study with median follow-up of 11.2 years. Predictors eGFR by the CKD-EPI (CKD Epidemiology Collaboration) creatinine equation (reference, 95 mL/min/1.73 m2 ) and urinary albumin-creatinine ratio (ACR; reference, 5 mg/g). Outcomes Cardiovascular events (coronary disease, stroke, and heart failure) and all-cause mortality. Measurements Adjusted HRs associated with eGFR and ACR in subgroups according to age, sex, and race. Results Cardiovascular risk significantly increased at eGFR