Official websites use .gov
A
.gov
website belongs to an official government organization in the
United States.
Secure .gov websites use HTTPS
A
lock
(
) or
https://
means you’ve safely connected to the .gov website. Share sensitive
information only on official, secure websites.
PubMed ID:
27151925
Public Release Type:
Journal
Publication Year: 2016
Affiliation: Department of Medicine, University of Illinois at Chicago, Chicago, Illinois; fischerm@uic.edu.; Center for Clinical Epidemiology and Biostatistics, Department of Epidemiology and Biostatistics, University of Pennsylvania, Philadelphia, Pennsylvania.; Department of Medicine, University of Illinois at Chicago, Chicago, Illinois.; Department of Medicine, University of Illinois at Chicago, Chicago, Illinois.; Center for Clinical Epidemiology and Biostatistics, Department of Epidemiology and Biostatistics, University of Pennsylvania, Philadelphia, Pennsylvania.; Department of Epidemiology, Tulane University, New Orleans, Louisiana.; Center for Clinical Epidemiology and Biostatistics, Department of Epidemiology and Biostatistics, University of Pennsylvania, Philadelphia, Pennsylvania.; Department of Medicine, University of California San Francisco, San Francisco, California.; National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Bethesda, Maryland.; Department of Medicine, University of Illinois at Chicago, Chicago, Illinois.; Department of Medicine, University of Michigan, Ann Arbor, Michigan.; Department of Medicine, The George Washington University, Washington, DC.; Kidney and Hypertension Unit, Joslin Diabetes Center and Nephrology Section, Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts; and.; Center for Clinical Epidemiology and Biostatistics, Department of Epidemiology and Biostatistics, University of Pennsylvania, Philadelphia, Pennsylvania.; Departments of Psychiatry, Neurology and Epidemiology, University of California San Francisco and San Francisco VA Medical Center, San Francisco, California.; Division of Research, Kaiser Permanente Northern California, Oakland, California.; Department of Medicine, University of Illinois at Chicago, Chicago, Illinois.
DOI:
https://doi.org/10.1681/ASN.2015050570
Authors:
Fischer Michael J, Hsu Jesse Y, Lora Claudia M, Ricardo Ana C, Anderson Amanda H, Bazzano Lydia, Cuevas Magdalena M, Hsu Chi-Yuan, Kusek John W, Renteria Amada, Ojo Akinlolu O, Raj Dominic S, Rosas Sylvia E, Pan Qiang, Yaffe Kristine, Go Alan S, Lash James P
Request IDs:
21097
Studies:
Chronic Renal Insufficiency Cohort Study
Although recommended approaches to CKD management are achieved less often in Hispanics than in non-Hispanics, whether long-term outcomes differ between these groups is unclear. In a prospective longitudinal analysis of participants enrolled into the Chronic Renal Insufficiency Cohort (CRIC) and Hispanic-CRIC Studies, we used Cox proportional hazards models to determine the association between race/ethnicity, CKD progression (50% eGFR loss or incident ESRD), incident ESRD, and all-cause mortality, and linear mixed-effects models to assess differences in eGFR slope. Among 3785 participants, 13% were Hispanic, 43% were non-Hispanic white (NHW), and 44% were non-Hispanic black (NHB). Over a median follow-up of 5.1 years for Hispanics and 6.8 years for non-Hispanics, 27.6% of all participants had CKD progression, 21.3% reached incident ESRD, and 18.3% died. Hispanics had significantly higher rates of CKD progression, incident ESRD, and mean annual decline in eGFR than did NHW (P<0.05) but not NHB. Hispanics had a mortality rate similar to that of NHW but lower than that of NHB (P<0.05). In adjusted analyses, the risk of CKD progression did not differ between Hispanics and NHW or NHB. However, among nondiabetic participants, compared with NHB, Hispanics had a lower risk of CKD progression (hazard ratio, 0.61; 95% confidence interval, 0.39 to 0.95) and incident ESRD (hazard ratio, 0.50; 95% confidence interval, 0.30 to 0.84). At higher levels of urine protein, Hispanics had a significantly lower risk of mortality than did non-Hispanics (P<0.05). Thus, important differences in CKD progression and mortality exist between Hispanics and non-Hispanics and may be affected by proteinuria and diabetes.
