Abstract
Rates of chronic kidney disease (CKD) progression, end stage kidney disease (ESKD), all-cause mortality, and cardiovascular (CVD) events among individuals with CKD vary widely across countries. Well-characterized demographic, comorbidity, and laboratory markers captured for prospective cohorts may explain, in part, such differences. To investigate whether core characteristics of individuals with CKD explain differences in rates of outcomes, we conducted an individual-level analysis of eight studies that are part of iNET-CKD, an international network of CKD cohort studies. Overall, the rate of CKD progression was 40 events/1000 person-year (95% confidence interval 39 - 41), 28 (27 - 29) for ESKD, 41 (40 - 42) for death, and 29 (28 - 30) for CVD events. However, standardized rates were highly heterogeneous across studies (over 92.5%). Interactions by study group on the association between baseline characteristics and outcomes were then identified. For example, the adjusted hazard ratio for CKD progression was 0.44 (95% confidence interval 0.35 – 0.56) for women vs. men among the Japanese (CKD-JAC), while it was 0.66 (0.59 – 0.75) among the Uruguayan (NRHP). The adjusted hazard ratio for ESKD was 2.02 (95% CI 1.88 – 2.17) per 10 units lower baseline eGFR among Americans (CRIC), while it was 3.01 (2.57 - 3.53) among Canadians (CanPREDDICT) (significant interaction for comparisons across all studies). The risks of CKD progression, ESKD, death, and CVD vary across countries even after accounting for the distributions of age, sex, comorbidities, and laboratory markers. Thus, our findings support the need for a better understanding of specific factors in different populations that explain this variation.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 1217-1233 |
| Number of pages | 17 |
| Journal | Kidney International |
| Volume | 96 |
| Issue number | 5 |
| DOIs | |
| State | Published - Nov 2019 |
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Keywords
- CKD
- CKD progression
- epidemiology
- international comparisons
- risk factors
ASJC Scopus subject areas
- Nephrology
Cite this
A collaborative, individual-level analysis compared longitudinal outcomes across the International Network of Chronic Kidney Disease (iNETCKD) cohorts. / iNET-CKD Collaborators.
In: Kidney International, Vol. 96, No. 5, 11.2019, p. 1217-1233.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - A collaborative, individual-level analysis compared longitudinal outcomes across the International Network of Chronic Kidney Disease (iNETCKD) cohorts
AU - iNET-CKD Collaborators
AU - Orlandi, Paula F.
AU - Huang, Jing
AU - Feldman, Harold I.
AU - Orlandi, Paula F.
AU - Huang, Jing
AU - Feldman, Harold I.
AU - Fukagawa, Masafumi
AU - Hoy, Wendy
AU - Jha, Vivekanand
AU - Oh, Kook Hwan
AU - Sola, Laura
AU - Cockwell, Paul
AU - Levin, Adeera
AU - Hoy, Wendy E.
AU - Wang, Zaimin
AU - Zhang, Jianzhen
AU - Healy, Helen G.
AU - Cockwell, Paul
AU - Fenton, Anthony
AU - Orlandi, Paula F.
AU - Nessel, Lisa
AU - Go, Alan
AU - Appel, Lawrence
AU - Feldman, Harold I.
AU - Oh, Kook Hwan
AU - Ahn, Curie
AU - Chae, Dong Wan
AU - Han, Seung Hyeok
AU - Levin, Adeera
AU - Djurdjev, Ognjenka
AU - Tang, Mila
AU - Sola, Laura
AU - Rios, Pablo G.
AU - Gadola, Liliana
AU - Fukagawa, Masafumi
AU - Hamano, Takayuki
AU - Fujii, Naohiko
AU - Imaizumi, Takahiro
AU - Jha, Vivekanand
AU - Yadav, Ashok Kumar
AU - Kumar, Vivek
PY - 2019/11
Y1 - 2019/11
N2 - Rates of chronic kidney disease (CKD) progression, end stage kidney disease (ESKD), all-cause mortality, and cardiovascular (CVD) events among individuals with CKD vary widely across countries. Well-characterized demographic, comorbidity, and laboratory markers captured for prospective cohorts may explain, in part, such differences. To investigate whether core characteristics of individuals with CKD explain differences in rates of outcomes, we conducted an individual-level analysis of eight studies that are part of iNET-CKD, an international network of CKD cohort studies. Overall, the rate of CKD progression was 40 events/1000 person-year (95% confidence interval 39 - 41), 28 (27 - 29) for ESKD, 41 (40 - 42) for death, and 29 (28 - 30) for CVD events. However, standardized rates were highly heterogeneous across studies (over 92.5%). Interactions by study group on the association between baseline characteristics and outcomes were then identified. For example, the adjusted hazard ratio for CKD progression was 0.44 (95% confidence interval 0.35 – 0.56) for women vs. men among the Japanese (CKD-JAC), while it was 0.66 (0.59 – 0.75) among the Uruguayan (NRHP). The adjusted hazard ratio for ESKD was 2.02 (95% CI 1.88 – 2.17) per 10 units lower baseline eGFR among Americans (CRIC), while it was 3.01 (2.57 - 3.53) among Canadians (CanPREDDICT) (significant interaction for comparisons across all studies). The risks of CKD progression, ESKD, death, and CVD vary across countries even after accounting for the distributions of age, sex, comorbidities, and laboratory markers. Thus, our findings support the need for a better understanding of specific factors in different populations that explain this variation.
AB - Rates of chronic kidney disease (CKD) progression, end stage kidney disease (ESKD), all-cause mortality, and cardiovascular (CVD) events among individuals with CKD vary widely across countries. Well-characterized demographic, comorbidity, and laboratory markers captured for prospective cohorts may explain, in part, such differences. To investigate whether core characteristics of individuals with CKD explain differences in rates of outcomes, we conducted an individual-level analysis of eight studies that are part of iNET-CKD, an international network of CKD cohort studies. Overall, the rate of CKD progression was 40 events/1000 person-year (95% confidence interval 39 - 41), 28 (27 - 29) for ESKD, 41 (40 - 42) for death, and 29 (28 - 30) for CVD events. However, standardized rates were highly heterogeneous across studies (over 92.5%). Interactions by study group on the association between baseline characteristics and outcomes were then identified. For example, the adjusted hazard ratio for CKD progression was 0.44 (95% confidence interval 0.35 – 0.56) for women vs. men among the Japanese (CKD-JAC), while it was 0.66 (0.59 – 0.75) among the Uruguayan (NRHP). The adjusted hazard ratio for ESKD was 2.02 (95% CI 1.88 – 2.17) per 10 units lower baseline eGFR among Americans (CRIC), while it was 3.01 (2.57 - 3.53) among Canadians (CanPREDDICT) (significant interaction for comparisons across all studies). The risks of CKD progression, ESKD, death, and CVD vary across countries even after accounting for the distributions of age, sex, comorbidities, and laboratory markers. Thus, our findings support the need for a better understanding of specific factors in different populations that explain this variation.
KW - CKD
KW - CKD progression
KW - epidemiology
KW - international comparisons
KW - risk factors
UR - http://www.scopus.com/inward/record.url?scp=85072752313&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85072752313&partnerID=8YFLogxK
U2 - 10.1016/j.kint.2019.07.024
DO - 10.1016/j.kint.2019.07.024
M3 - Article
C2 - 31570197
AN - SCOPUS:85072752313
VL - 96
SP - 1217
EP - 1233
JO - Kidney International
JF - Kidney International
SN - 0085-2538
IS - 5
ER -