The relation of C--reactive protein to chronic kidney disease in African Americans: the Jackson Heart Study.
BACKGROUND
African Americans have an increased incidence and worse prognosis with chronic kidney disease (CKD--estimated glomerular filtration rate [eGFR] <60 ml/min/1.73 m2) than their counterparts of European-descent. Inflammation has been related to renal disease in non-Hispanic whites, but there are limited data on the role of inflammation in renal dysfunction in African Americans in the community.


METHODS
We examined the cross-sectional relation of log transformed C-reactive protein (CRP) to renal function (eGFR by Modification of Diet and Renal Disease equation) in African American participants of the community-based Jackson Heart Study's first examination (2000 to 2004). We conducted multivariable linear regression relating CRP to eGFR adjusting for age, sex, body mass index, systolic and diastolic blood pressure, diabetes, total/HDL cholesterol, triglycerides, smoking, antihypertensive therapy, lipid lowering therapy, hormone replacement therapy, and prevalent cardiovascular disease events. In a secondary analysis we assessed the association of CRP with albuminuria (defined as albumin-to-creatinine ratio > 30 mg/g).


RESULTS
Participants (n = 4320, 63.2% women) had a mean age +/- SD of 54.0 +/- 12.8 years. The prevalence of CKD was 5.2% (n = 228 cases). In multivariable regression, CRP concentrations were higher in those with CKD compared to those without CKD (mean CRP 3.2 +/- 1.1 mg/L vs. 2.4 +/- 1.0 mg/L, respectively p < 0.0001). CRP was significantly associated with albuminuria in sex and age adjusted model however not in the multivariable adjusted model (p > 0.05).


CONCLUSIONS
CRP was associated with CKD however not albuminuria in multivariable-adjusted analyses. The study of inflammation in the progression of renal disease in African Americans merits further investigation.
Fox
Ervin R
ER
Department of Medicine, University of Mississippi School of Medicine, Jackson, MS, USA. efox@medicine.umsmed.edu
Benjamin
Emelia J
EJ
Sarpong
Daniel F
DF
Nagarajarao
Harsha
H
Taylor
Jason K
JK
Steffes
Michael W
MW
Salahudeen
Abdullah K
AK
Flessner
Michael F
MF
Akylbekova
Ermeg L
EL
Fox
Caroline S
CS
Garrison
Robert J
RJ
Taylor
Herman A
HA
D000328:Adult; D001741:Black or African American / Q000706:statistics & numerical data*; D000368:Aged; D000419:Albuminuria / Q000097:blood / Q000208:ethnology; D002097:C-Reactive Protein / Q000378:metabolism*; D005260:Female; D005919:Glomerular Filtration Rate; D006801:Humans; D015994:Incidence; D007677:Kidney Function Tests; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D015995:Prevalence; D051436:Renal Insufficiency, Chronic / Q000097:blood* / Q000208:ethnology*; D012307:Risk Factors
D002097:C-Reactive Protein