title: Relative risks of chronic kidney disease for mortality and end-stage renal disease across races are similar.
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.
authors: 1] Institute of Population Science, National Health Research Institutes, Zhunan, Taiwan [2] China Medical University Hospital, Taichung, Taiwan.
authors: Chi Pang
authors: CP
authors: Wen
authors: Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA.
authors: Kunihiro
authors: K
authors: Matsushita
authors: Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA.
authors: Josef
authors: J
authors: Coresh
authors: Dialysis Unit, University Hospital of The Ryukyus, Nishihara, Japan.
authors: Kunitoshi
authors: K
authors: Iseki
authors: Department of Community Health Sciences, The Aga Khan University, Karachi, Pakistan.
authors: Muhammad
authors: M
authors: Islam
authors: Kidney Research Institute, University of Washington, Seattle, Washington, USA.
authors: Ronit
authors: R
authors: Katz
authors: Department of Medicine, Emory University School of Medicine, Atlanta, Georgia, USA.
authors: William
authors: W
authors: McClellan
authors: Division of Nephrology, University of California, San Francisco, California, USA.
authors: Carmen A
authors: CA
authors: Peralta
authors: Renal Division, Department of Medicine, Peking University First Hospital, Institute of Nephrology, Peking University, Key Laboratory of Renal Disease, Ministry of Health of China, Beijing, China.
authors: HaiYan
authors: H
authors: Wang
authors: Department of Clinical Pharmacology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.
authors: Dick
authors: D
authors: de Zeeuw
authors: 1] Department of Medicine, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, USA [2] Department of Population Health Sciences, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, USA.
authors: Brad C
authors: BC
authors: Astor
authors: Department of Nephrology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.
authors: Ron T
authors: RT
authors: Gansevoort
authors: Division of Nephrology, Tufts Medical Center, Boston, Massachusetts, USA.
authors: Andrew S
authors: AS
authors: Levey
authors: Division of Nephrology UBC, St Pauls Hospital, Vancouver, British Columbia, Canada.
authors: Adeera
authors: A
authors: Levin
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000419:Albuminuria / Q000208:ethnology; D044466:Asian People / Q000706:statistics & numerical data; D044383:Black People / Q000706:statistics & numerical data; D002318:Cardiovascular Diseases / Q000208:ethnology / Q000401:mortality; D015331:Cohort Studies; D003404:Creatinine / Q000652:urine; D005260:Female; D005919:Glomerular Filtration Rate; D006801:Humans; D007676:Kidney Failure, Chronic / Q000208:ethnology / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D051436:Renal Insufficiency, Chronic / Q000208:ethnology* / Q000401:mortality* / Q000503:physiopathology; D012307:Risk Factors; D044465:White People / Q000706:statistics & numerical data
chemical_list: D003404:Creatinine