Association of Kidney Disease Outcomes With Risk Factors for CKD: Findings From the Chronic Renal Insufficiency Cohort (CRIC) Study

Background Various indicators of progression of chronic kidney disease (CKD) have been used as outcomes in clinical research studies. The effect of using varying measures on the association of risk factors with CKD progression has not been well characterized. Study Design Prospective cohort study. S...

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Veröffentlicht in:American journal of kidney diseases 2014-02, Vol.63 (2), p.236-243
Hauptverfasser: Yang, Wei, PhD, Xie, Dawei, PhD, Anderson, Amanda H., PhD, Joffe, Marshall M., MD, PhD, Greene, Tom, PhD, Teal, Valerie, MS, Hsu, Chi-yuan, MD, Fink, Jeffrey C., MD, He, Jiang, MD, PhD, Lash, James P., MD, Ojo, Akinlolu, MD, PhD, Rahman, Mahboob, MD, Nessel, Lisa, MS, Kusek, John W., PhD, Feldman, Harold I., MD, MSCE
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container_issue 2
container_start_page 236
container_title American journal of kidney diseases
container_volume 63
creator Yang, Wei, PhD
Xie, Dawei, PhD
Anderson, Amanda H., PhD
Joffe, Marshall M., MD, PhD
Greene, Tom, PhD
Teal, Valerie, MS
Hsu, Chi-yuan, MD
Fink, Jeffrey C., MD
He, Jiang, MD, PhD
Lash, James P., MD
Ojo, Akinlolu, MD, PhD
Rahman, Mahboob, MD
Nessel, Lisa, MS
Kusek, John W., PhD
Feldman, Harold I., MD, MSCE
description Background Various indicators of progression of chronic kidney disease (CKD) have been used as outcomes in clinical research studies. The effect of using varying measures on the association of risk factors with CKD progression has not been well characterized. Study Design Prospective cohort study. Setting & Participants The Chronic Renal Insufficiency Cohort (CRIC) Study (N = 3,939) enrolled men and women with mild to moderate CKD, 48% of whom had diabetes and 42% were self-reported black race. Predictors Age, race, sex, diabetes, baseline estimated glomerular filtration rate (eGFR), proteinuria, and other established CKD risk factors. Outcomes Death, end-stage renal disease (ESRD), and eGFR events, including: (1) eGFR halving, (2) eGFR < 15 mL/min/1.73 m2 , (3) eGFR halving and 
doi_str_mv 10.1053/j.ajkd.2013.08.028
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The effect of using varying measures on the association of risk factors with CKD progression has not been well characterized. Study Design Prospective cohort study. Setting &amp; Participants The Chronic Renal Insufficiency Cohort (CRIC) Study (N = 3,939) enrolled men and women with mild to moderate CKD, 48% of whom had diabetes and 42% were self-reported black race. Predictors Age, race, sex, diabetes, baseline estimated glomerular filtration rate (eGFR), proteinuria, and other established CKD risk factors. Outcomes Death, end-stage renal disease (ESRD), and eGFR events, including: (1) eGFR halving, (2) eGFR &lt; 15 mL/min/1.73 m2 , (3) eGFR halving and &lt;15 mL/min/1.73 m2 , (4) eGFR decrease of 20 mL/min/1.73 m2 , (5) eGFR halving or decrease of 20 mL/min/1.73 m2 , and (6) eGFR decrease of 25% and change in CKD stage. Results Mean entry eGFR was 44.9 mL/min/1.73 m2 . Annual rates of death, ESRD, and eGFR halving were 2.5%, 4.0%, and 6.1%, respectively, during an average follow-up of 5.4 years. Associations between risk factors and ESRD and eGFR events were similar across different definitions. However, these associations were substantially different from those with death. HRs for ESRD, eGFR halving, and death in the highest compared to the lowest proteinuria category were 11.83 (95% CI, 8.40-16.65), 11.19 (95% CI, 8.53-14.68), and 1.47 (95% CI, 1.10-1.96), respectively. Limitations Participants may not be representative of the entire CKD population. Conclusions Using ESRD or eGFR events, but not death, in the definition of kidney disease outcomes is appropriate in follow-up studies to identify risk factors for CKD progression.</description><identifier>ISSN: 0272-6386</identifier><identifier>EISSN: 1523-6838</identifier><identifier>DOI: 10.1053/j.ajkd.2013.08.028</identifier><identifier>PMID: 24182662</identifier><language>eng</language><publisher>New York, NY: Elsevier Inc</publisher><subject>Adult ; Aged ; Biological and medical sciences ; chronic kidney disease (CKD) ; Chronic Renal Insufficiency Cohort (CRIC) ; Cohort Studies ; decreased estimated glomerular filtration rate (eGFR) ; disease trajectory ; end-stage renal disease (ESRD) ; estimated glomerular filtration rate (eGFR) ; Female ; Follow-Up Studies ; Glomerular Filtration Rate - physiology ; Humans ; Kidney disease progression ; Kidneys ; longitudinal outcome ; Male ; Medical sciences ; Middle Aged ; mortality risk ; Nephrology ; Nephrology. Urinary tract diseases ; Nephropathies. Renovascular diseases. Renal failure ; Prospective Studies ; Renal failure ; renal function ; Renal Insufficiency, Chronic - diagnosis ; Renal Insufficiency, Chronic - epidemiology ; Renal Insufficiency, Chronic - physiopathology ; Risk Factors ; Treatment Outcome ; Urinary system involvement in other diseases. Miscellaneous ; Young Adult</subject><ispartof>American journal of kidney diseases, 2014-02, Vol.63 (2), p.236-243</ispartof><rights>National Kidney Foundation, Inc.</rights><rights>2014 National Kidney Foundation, Inc.</rights><rights>2015 INIST-CNRS</rights><rights>Copyright © 2014 National Kidney Foundation, Inc. All rights reserved.</rights><rights>2013 The National Kidney Foundation, Inc. Published by Elsevier Inc. All rights reserved. 2013</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c540t-df4a8c394a2a3af91407d0e1aa08ae45b3dddaa10684d973c9fed5568fabebce3</citedby><cites>FETCH-LOGICAL-c540t-df4a8c394a2a3af91407d0e1aa08ae45b3dddaa10684d973c9fed5568fabebce3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.sciencedirect.com/science/article/pii/S0272638613012237$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>230,314,776,780,881,3537,27901,27902,65534</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&amp;idt=28312630$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/24182662$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Yang, Wei, PhD</creatorcontrib><creatorcontrib>Xie, Dawei, PhD</creatorcontrib><creatorcontrib>Anderson, Amanda H., PhD</creatorcontrib><creatorcontrib>Joffe, Marshall M., MD, PhD</creatorcontrib><creatorcontrib>Greene, Tom, PhD</creatorcontrib><creatorcontrib>Teal, Valerie, MS</creatorcontrib><creatorcontrib>Hsu, Chi-yuan, MD</creatorcontrib><creatorcontrib>Fink, Jeffrey C., MD</creatorcontrib><creatorcontrib>He, Jiang, MD, PhD</creatorcontrib><creatorcontrib>Lash, James P., MD</creatorcontrib><creatorcontrib>Ojo, Akinlolu, MD, PhD</creatorcontrib><creatorcontrib>Rahman, Mahboob, MD</creatorcontrib><creatorcontrib>Nessel, Lisa, MS</creatorcontrib><creatorcontrib>Kusek, John W., PhD</creatorcontrib><creatorcontrib>Feldman, Harold I., MD, MSCE</creatorcontrib><creatorcontrib>CRIC Study Investigators</creatorcontrib><title>Association of Kidney Disease Outcomes With Risk Factors for CKD: Findings From the Chronic Renal Insufficiency Cohort (CRIC) Study</title><title>American journal of kidney diseases</title><addtitle>Am J Kidney Dis</addtitle><description>Background Various indicators of progression of chronic kidney disease (CKD) have been used as outcomes in clinical research studies. The effect of using varying measures on the association of risk factors with CKD progression has not been well characterized. Study Design Prospective cohort study. Setting &amp; Participants The Chronic Renal Insufficiency Cohort (CRIC) Study (N = 3,939) enrolled men and women with mild to moderate CKD, 48% of whom had diabetes and 42% were self-reported black race. Predictors Age, race, sex, diabetes, baseline estimated glomerular filtration rate (eGFR), proteinuria, and other established CKD risk factors. Outcomes Death, end-stage renal disease (ESRD), and eGFR events, including: (1) eGFR halving, (2) eGFR &lt; 15 mL/min/1.73 m2 , (3) eGFR halving and &lt;15 mL/min/1.73 m2 , (4) eGFR decrease of 20 mL/min/1.73 m2 , (5) eGFR halving or decrease of 20 mL/min/1.73 m2 , and (6) eGFR decrease of 25% and change in CKD stage. Results Mean entry eGFR was 44.9 mL/min/1.73 m2 . Annual rates of death, ESRD, and eGFR halving were 2.5%, 4.0%, and 6.1%, respectively, during an average follow-up of 5.4 years. Associations between risk factors and ESRD and eGFR events were similar across different definitions. However, these associations were substantially different from those with death. HRs for ESRD, eGFR halving, and death in the highest compared to the lowest proteinuria category were 11.83 (95% CI, 8.40-16.65), 11.19 (95% CI, 8.53-14.68), and 1.47 (95% CI, 1.10-1.96), respectively. Limitations Participants may not be representative of the entire CKD population. Conclusions Using ESRD or eGFR events, but not death, in the definition of kidney disease outcomes is appropriate in follow-up studies to identify risk factors for CKD progression.</description><subject>Adult</subject><subject>Aged</subject><subject>Biological and medical sciences</subject><subject>chronic kidney disease (CKD)</subject><subject>Chronic Renal Insufficiency Cohort (CRIC)</subject><subject>Cohort Studies</subject><subject>decreased estimated glomerular filtration rate (eGFR)</subject><subject>disease trajectory</subject><subject>end-stage renal disease (ESRD)</subject><subject>estimated glomerular filtration rate (eGFR)</subject><subject>Female</subject><subject>Follow-Up Studies</subject><subject>Glomerular Filtration Rate - physiology</subject><subject>Humans</subject><subject>Kidney disease progression</subject><subject>Kidneys</subject><subject>longitudinal outcome</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>mortality risk</subject><subject>Nephrology</subject><subject>Nephrology. Urinary tract diseases</subject><subject>Nephropathies. Renovascular diseases. Renal failure</subject><subject>Prospective Studies</subject><subject>Renal failure</subject><subject>renal function</subject><subject>Renal Insufficiency, Chronic - diagnosis</subject><subject>Renal Insufficiency, Chronic - epidemiology</subject><subject>Renal Insufficiency, Chronic - physiopathology</subject><subject>Risk Factors</subject><subject>Treatment Outcome</subject><subject>Urinary system involvement in other diseases. Miscellaneous</subject><subject>Young Adult</subject><issn>0272-6386</issn><issn>1523-6838</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2014</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kstuEzEUQEcIREPhB1ggb5DKIsGPGceDUKVq2kDUSpVSEEvrxr7TOJnYxZ6plA_of_Rb-mVMSCiPBSsvfO7z3Cx7zeiI0UK8X45gubIjTpkYUTWiXD3JBqzgYiiVUE-zAeVjPpRCyYPsRUpLSmkppHyeHfCcKS4lH2R3JykF46B1wZNQk3NnPW7IqUsICcll15qwxkS-uXZBZi6tyARMG2IidYgP99X56Qcycd46f53IJIY1aRdIqkUM3hkyQw8NmfrU1bUzDr3ZkCosQmwf7o-q2bR6R67azm5eZs9qaBK-2r-H2dfJ2Zfq8_Di8tO0OrkYmiKn7dDWOSgjyhw4CKhLltOxpcgAqALMi7mw1gIwKlVuy7EwZY22KKSqYY5zg-IwO97lvenma7QGfRuh0TfRrSFudACn__7xbqGvw63ua0qlij7B0T5BDN87TK1eu2SwacBj6JJmecllqXihepTvUBNDShHrxzKM6q0_vdRbf3rrT1Ole3990Js_G3wM-SWsB97uAUgGmjqCNy795pRgXAracx93HPbrvHUYdfq5f7Quomm1De7_fRz_E24a1xuFZoUbTMvQxd5sP69OXFN9tb207aExQRnnYix-AKLp0eg</recordid><startdate>20140201</startdate><enddate>20140201</enddate><creator>Yang, Wei, PhD</creator><creator>Xie, Dawei, PhD</creator><creator>Anderson, Amanda H., PhD</creator><creator>Joffe, Marshall M., MD, PhD</creator><creator>Greene, Tom, PhD</creator><creator>Teal, Valerie, MS</creator><creator>Hsu, Chi-yuan, MD</creator><creator>Fink, Jeffrey C., MD</creator><creator>He, Jiang, MD, PhD</creator><creator>Lash, James P., MD</creator><creator>Ojo, Akinlolu, MD, PhD</creator><creator>Rahman, Mahboob, MD</creator><creator>Nessel, Lisa, MS</creator><creator>Kusek, John W., PhD</creator><creator>Feldman, Harold I., MD, MSCE</creator><general>Elsevier Inc</general><general>Elsevier</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><scope>5PM</scope></search><sort><creationdate>20140201</creationdate><title>Association of Kidney Disease Outcomes With Risk Factors for CKD: Findings From the Chronic Renal Insufficiency Cohort (CRIC) Study</title><author>Yang, Wei, PhD ; Xie, Dawei, PhD ; Anderson, Amanda H., PhD ; Joffe, Marshall M., MD, PhD ; Greene, Tom, PhD ; Teal, Valerie, MS ; Hsu, Chi-yuan, MD ; Fink, Jeffrey C., MD ; He, Jiang, MD, PhD ; Lash, James P., MD ; Ojo, Akinlolu, MD, PhD ; Rahman, Mahboob, MD ; Nessel, Lisa, MS ; Kusek, John W., PhD ; Feldman, Harold I., MD, MSCE</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c540t-df4a8c394a2a3af91407d0e1aa08ae45b3dddaa10684d973c9fed5568fabebce3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2014</creationdate><topic>Adult</topic><topic>Aged</topic><topic>Biological and medical sciences</topic><topic>chronic kidney disease (CKD)</topic><topic>Chronic Renal Insufficiency Cohort (CRIC)</topic><topic>Cohort Studies</topic><topic>decreased estimated glomerular filtration rate (eGFR)</topic><topic>disease trajectory</topic><topic>end-stage renal disease (ESRD)</topic><topic>estimated glomerular filtration rate (eGFR)</topic><topic>Female</topic><topic>Follow-Up Studies</topic><topic>Glomerular Filtration Rate - physiology</topic><topic>Humans</topic><topic>Kidney disease progression</topic><topic>Kidneys</topic><topic>longitudinal outcome</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>mortality risk</topic><topic>Nephrology</topic><topic>Nephrology. Urinary tract diseases</topic><topic>Nephropathies. Renovascular diseases. Renal failure</topic><topic>Prospective Studies</topic><topic>Renal failure</topic><topic>renal function</topic><topic>Renal Insufficiency, Chronic - diagnosis</topic><topic>Renal Insufficiency, Chronic - epidemiology</topic><topic>Renal Insufficiency, Chronic - physiopathology</topic><topic>Risk Factors</topic><topic>Treatment Outcome</topic><topic>Urinary system involvement in other diseases. Miscellaneous</topic><topic>Young Adult</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Yang, Wei, PhD</creatorcontrib><creatorcontrib>Xie, Dawei, PhD</creatorcontrib><creatorcontrib>Anderson, Amanda H., PhD</creatorcontrib><creatorcontrib>Joffe, Marshall M., MD, PhD</creatorcontrib><creatorcontrib>Greene, Tom, PhD</creatorcontrib><creatorcontrib>Teal, Valerie, MS</creatorcontrib><creatorcontrib>Hsu, Chi-yuan, MD</creatorcontrib><creatorcontrib>Fink, Jeffrey C., MD</creatorcontrib><creatorcontrib>He, Jiang, MD, PhD</creatorcontrib><creatorcontrib>Lash, James P., MD</creatorcontrib><creatorcontrib>Ojo, Akinlolu, MD, PhD</creatorcontrib><creatorcontrib>Rahman, Mahboob, MD</creatorcontrib><creatorcontrib>Nessel, Lisa, MS</creatorcontrib><creatorcontrib>Kusek, John W., PhD</creatorcontrib><creatorcontrib>Feldman, Harold I., MD, MSCE</creatorcontrib><creatorcontrib>CRIC Study Investigators</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>American journal of kidney diseases</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Yang, Wei, PhD</au><au>Xie, Dawei, PhD</au><au>Anderson, Amanda H., PhD</au><au>Joffe, Marshall M., MD, PhD</au><au>Greene, Tom, PhD</au><au>Teal, Valerie, MS</au><au>Hsu, Chi-yuan, MD</au><au>Fink, Jeffrey C., MD</au><au>He, Jiang, MD, PhD</au><au>Lash, James P., MD</au><au>Ojo, Akinlolu, MD, PhD</au><au>Rahman, Mahboob, MD</au><au>Nessel, Lisa, MS</au><au>Kusek, John W., PhD</au><au>Feldman, Harold I., MD, MSCE</au><aucorp>CRIC Study Investigators</aucorp><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Association of Kidney Disease Outcomes With Risk Factors for CKD: Findings From the Chronic Renal Insufficiency Cohort (CRIC) Study</atitle><jtitle>American journal of kidney diseases</jtitle><addtitle>Am J Kidney Dis</addtitle><date>2014-02-01</date><risdate>2014</risdate><volume>63</volume><issue>2</issue><spage>236</spage><epage>243</epage><pages>236-243</pages><issn>0272-6386</issn><eissn>1523-6838</eissn><abstract>Background Various indicators of progression of chronic kidney disease (CKD) have been used as outcomes in clinical research studies. The effect of using varying measures on the association of risk factors with CKD progression has not been well characterized. Study Design Prospective cohort study. Setting &amp; Participants The Chronic Renal Insufficiency Cohort (CRIC) Study (N = 3,939) enrolled men and women with mild to moderate CKD, 48% of whom had diabetes and 42% were self-reported black race. Predictors Age, race, sex, diabetes, baseline estimated glomerular filtration rate (eGFR), proteinuria, and other established CKD risk factors. Outcomes Death, end-stage renal disease (ESRD), and eGFR events, including: (1) eGFR halving, (2) eGFR &lt; 15 mL/min/1.73 m2 , (3) eGFR halving and &lt;15 mL/min/1.73 m2 , (4) eGFR decrease of 20 mL/min/1.73 m2 , (5) eGFR halving or decrease of 20 mL/min/1.73 m2 , and (6) eGFR decrease of 25% and change in CKD stage. Results Mean entry eGFR was 44.9 mL/min/1.73 m2 . Annual rates of death, ESRD, and eGFR halving were 2.5%, 4.0%, and 6.1%, respectively, during an average follow-up of 5.4 years. Associations between risk factors and ESRD and eGFR events were similar across different definitions. However, these associations were substantially different from those with death. HRs for ESRD, eGFR halving, and death in the highest compared to the lowest proteinuria category were 11.83 (95% CI, 8.40-16.65), 11.19 (95% CI, 8.53-14.68), and 1.47 (95% CI, 1.10-1.96), respectively. Limitations Participants may not be representative of the entire CKD population. Conclusions Using ESRD or eGFR events, but not death, in the definition of kidney disease outcomes is appropriate in follow-up studies to identify risk factors for CKD progression.</abstract><cop>New York, NY</cop><pub>Elsevier Inc</pub><pmid>24182662</pmid><doi>10.1053/j.ajkd.2013.08.028</doi><tpages>8</tpages><oa>free_for_read</oa></addata></record>
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subjects Adult
Aged
Biological and medical sciences
chronic kidney disease (CKD)
Chronic Renal Insufficiency Cohort (CRIC)
Cohort Studies
decreased estimated glomerular filtration rate (eGFR)
disease trajectory
end-stage renal disease (ESRD)
estimated glomerular filtration rate (eGFR)
Female
Follow-Up Studies
Glomerular Filtration Rate - physiology
Humans
Kidney disease progression
Kidneys
longitudinal outcome
Male
Medical sciences
Middle Aged
mortality risk
Nephrology
Nephrology. Urinary tract diseases
Nephropathies. Renovascular diseases. Renal failure
Prospective Studies
Renal failure
renal function
Renal Insufficiency, Chronic - diagnosis
Renal Insufficiency, Chronic - epidemiology
Renal Insufficiency, Chronic - physiopathology
Risk Factors
Treatment Outcome
Urinary system involvement in other diseases. Miscellaneous
Young Adult
title Association of Kidney Disease Outcomes With Risk Factors for CKD: Findings From the Chronic Renal Insufficiency Cohort (CRIC) Study
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