Title | Relative risks of chronic kidney disease for mortality and end-stage renal disease across races are similar |
Authors | Wen, Chi Pang Matsushita, Kunihiro Coresh, Josef Iseki, Kunitoshi Islam, Muhammad Katz, Ronit McClellan, William Peralta, Carmen A. Wang, HaiYan de Zeeuw, Dick Astor, Brad C. Gansevoort, Ron T. Levey, Andrew S. Levin, Adeera |
Affiliation | Natl Hlth Res Inst, Inst Populat Sci, Zhunan, Taiwan. China Med Univ Hosp, Taichung, Taiwan. Johns Hopkins Bloomberg Sch Publ Hlth, Dept Epidemiol, Baltimore, MD USA. Univ Hosp Ryukyus, Dialysis Unit, Nishihara, Okinawa, Japan. Aga Khan Univ, Dept Community Hlth Sci, Karachi, Pakistan. Univ Washington, Kidney Res Inst, Seattle, WA 98195 USA. Emory Univ, Sch Med, Dept Med, Atlanta, GA USA. Univ Calif San Francisco, Div Nephrol, San Francisco, CA 94143 USA. Peking Univ, Key Lab Renal Dis, Minist Hlth China, Renal Div,Dept Med,Inst Nephrol,Hosp 1, Beijing, Peoples R China. Univ Groningen, Univ Med Ctr Groningen, Dept Clin Pharmacol, Groningen, Netherlands. Univ Wisconsin, Dept Med, Sch Med & Publ Hlth, Madison, WI USA. Univ Wisconsin, Dept Populat Hlth Sci, Sch Med & Publ Hlth, Madison, WI USA. Univ Groningen, Univ Med Ctr Groningen, Dept Nephrol, Groningen, Netherlands. Tufts Med Ctr, Div Nephrol, Boston, MA USA. St Pauls Hosp, Div Nephrol UBC, Vancouver, BC V6Z 1Y6, Canada. Chron Kidney Dis Prognosis Consortium Data Coord, 615 N Wolfe St, Baltimore, MD 21205 USA. |
Keywords | chronic kidney disease end-stage renal disease epidemiology and outcomes ethnicity mortality risk GLOMERULAR-FILTRATION-RATE CKD-EPI EQUATION COLLABORATIVE METAANALYSIS POPULATION COHORTS HIGHER ALBUMINURIA ALL-CAUSE INDIVIDUALS ASSOCIATIONS PROTEINURIA PREVALENCE |
Issue Date | 2014 |
Publisher | 国际肾脏学 |
Citation | KIDNEY INTERNATIONAL.2014,86,(4),819-827. |
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. |
URI | http://hdl.handle.net/20.500.11897/190218 |
ISSN | 0085-2538 |
DOI | 10.1038/ki.2013.553 |
Indexed | SCI(E) PubMed |
Appears in Collections: | 第一医院 |