TY - JOUR
T1 - Racial and ethnic differences in kidney function decline among persons without chronic kidney disease
AU - Peralta, Carmen A.
AU - Katz, Ronit
AU - DeBoer, Ian
AU - Ix, Joachim
AU - Sarnak, Mark
AU - Kramer, Holly
AU - Siscovick, David
AU - Shea, Steven
AU - Szklo, Moyses
AU - Shlipak, Michael
PY - 2011/7
Y1 - 2011/7
N2 - Whether the rate of kidney function decline before the onset of CKD differs among racial and ethnic groups remains unclear. Here, we evaluated kidney function decline and incident CKD among white, black, Hispanic, and Chinese participants in the Multi-Ethnic Study of Atherosclerosis (MESA) during 5 years of follow-up. We estimated GFR using both cystatin C (eGFRcys) and creatinine (eGFRcreat). The definition of incident CKD required eGFRcys <60 ml/min per 1.73 m2 and a decline in eGFRcys ≥1 ml/min per year. Among participants with eGFRcreat <60 ml/min per 1.73 m2 at baseline, blacks had a significantly higher rate of kidney function decline than whites (0.31 ml/min per 1.73 m2/yr faster on average, P = 0.001), even after adjusting for multiple potential confounders. Among Hispanics, Dominicans and Puerto Ricans had faster rates of decline than whites (0.55 and 0.47 ml/min per 1.73 m2/yr faster, respectively). Mexicans, South Americans, or other Hispanics had similar rates of decline compared to whites. We did not detect significant differences in the rates of kidney function decline among Chinese and white participants. Among those with normal or near-normal kidney function at baseline, blacks and Hispanics had the highest rates of incident CKD during follow-up. Adjustment for comorbidities attenuated some of these differences. In conclusion, the average rate of kidney function decline before the onset of CKD differs among racial and ethnic groups. Traditional risk factors do not explain these differences fully, highlighting the need to explore these disparities.
AB - Whether the rate of kidney function decline before the onset of CKD differs among racial and ethnic groups remains unclear. Here, we evaluated kidney function decline and incident CKD among white, black, Hispanic, and Chinese participants in the Multi-Ethnic Study of Atherosclerosis (MESA) during 5 years of follow-up. We estimated GFR using both cystatin C (eGFRcys) and creatinine (eGFRcreat). The definition of incident CKD required eGFRcys <60 ml/min per 1.73 m2 and a decline in eGFRcys ≥1 ml/min per year. Among participants with eGFRcreat <60 ml/min per 1.73 m2 at baseline, blacks had a significantly higher rate of kidney function decline than whites (0.31 ml/min per 1.73 m2/yr faster on average, P = 0.001), even after adjusting for multiple potential confounders. Among Hispanics, Dominicans and Puerto Ricans had faster rates of decline than whites (0.55 and 0.47 ml/min per 1.73 m2/yr faster, respectively). Mexicans, South Americans, or other Hispanics had similar rates of decline compared to whites. We did not detect significant differences in the rates of kidney function decline among Chinese and white participants. Among those with normal or near-normal kidney function at baseline, blacks and Hispanics had the highest rates of incident CKD during follow-up. Adjustment for comorbidities attenuated some of these differences. In conclusion, the average rate of kidney function decline before the onset of CKD differs among racial and ethnic groups. Traditional risk factors do not explain these differences fully, highlighting the need to explore these disparities.
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U2 - 10.1681/ASN.2010090960
DO - 10.1681/ASN.2010090960
M3 - Article
C2 - 21700831
AN - SCOPUS:79960135935
SN - 1046-6673
VL - 22
SP - 1327
EP - 1334
JO - Journal of the American Society of Nephrology
JF - Journal of the American Society of Nephrology
IS - 7
ER -