CKD in Hispanics: Baseline Characteristics From the CRIC (Chronic Renal Insufficiency Cohort) and Hispanic-CRIC Studies

被引:100
|
作者
Fischer, Michael J. [1 ,2 ,3 ]
Go, Alan S. [4 ,5 ,6 ,7 ]
Lora, Claudia M. [1 ,2 ]
Ackerson, Lynn [4 ]
Cohan, Janet [1 ,2 ]
Kusek, John W. [8 ]
Mercado, Alejandro [1 ,2 ]
Ojo, Akinlolu [9 ]
Ricardo, Ana C. [1 ,2 ]
Rosen, Leigh K. [10 ]
Tao, Kaixiang [10 ]
Xie, Dawei [10 ]
Feldman, Harold I. [10 ,11 ]
Lash, James P. [1 ,2 ]
机构
[1] Jesse Brown VA Med Ctr, Chicago, IL USA
[2] Univ Illinois, Med Ctr, Chicago, IL USA
[3] VA Hosp, Ctr Management Complex Chron Care, Hines, IL USA
[4] Kaiser Permanente No Calif, Div Res, Oakland, CA USA
[5] Univ Calif San Francisco, Dept Epidemiol, San Francisco, CA 94143 USA
[6] Univ Calif San Francisco, Dept Biostat, San Francisco, CA 94143 USA
[7] Univ Calif San Francisco, Dept Med, San Francisco, CA USA
[8] NIDDK, NIH, Bethesda, MD USA
[9] Univ Michigan, Dept Med, Ann Arbor, MI 48109 USA
[10] Univ Penn, Ctr Clin Epidemiol & Biostatist, Philadelphia, PA 19104 USA
[11] Univ Penn, Dept Med, Philadelphia, PA 19104 USA
基金
美国国家卫生研究院;
关键词
Chronic kidney disease; Hispanics; epidemiology; 3RD NATIONAL-HEALTH; CHRONIC KIDNEY-DISEASE; UNITED-STATES; HEMODIALYSIS-PATIENTS; DIABETIC-NEPHROPATHY; SURVIVAL ADVANTAGE; RACIAL-DIFFERENCES; DIALYSIS OUTCOMES; ETHNIC-GROUPS; NHANES-III;
D O I
10.1053/j.ajkd.2011.05.010
中图分类号
R5 [内科学]; R69 [泌尿科学(泌尿生殖系疾病)];
学科分类号
1002 ; 100201 ;
摘要
Background: Little is known regarding chronic kidney disease (CKD) in Hispanics. We compared baseline characteristics of Hispanic participants in the Chronic Renal Insufficiency Cohort (CRIC) and Hispanic-CRIC (H-CRIC) Studies with non-Hispanic CRIC participants. Study Design: Cross-sectional analysis. Setting & Participants: Participants were aged 21-74 years with CKD using age-based estimated glomerular filtration rate (eGFR) at enrollment into the CRIC/H-CRIC Studies. H-CRIC included Hispanics recruited at the University of Illinois in 2005-2008, whereas CRIC included Hispanics and non-Hispanics recruited at 7 clinical centers in 2003-2007. Factor: Race/ethnicity. Outcomes: Blood pressure, angiotensin-converting enzyme (ACE)-inhibitor/angiotensin receptor blocker (ARB) use, and CKD-associated complications. Measurements: Demographic characteristics, laboratory data, blood pressure, and medications were assessed using standard techniques and protocols. Results: Of H-CRIC/CRIC participants, 497 were Hispanic, 1,650 were non-Hispanic black, and 1,638 were non-Hispanic white. Low income and educational attainment were nearly twice as prevalent in Hispanics compared with non-Hispanics (P < 0.01). Hispanics had self-reported diabetes (67%) more frequently than non-Hispanic blacks (51%) and whites (40%; P < 0.01). Blood pressure > 130/80 mm Hg was more common in Hispanics (62%) than blacks (57%) and whites (35%; P < 0.05), and abnormalities in hematologic, metabolic, and bone metabolism parameters were more prevalent in Hispanics (P < 0.05), even after stratifying by entry eGFR. Hispanics had the lowest use of ACE inhibitors/ARBs among the high-risk subgroups, including participants with diabetes, proteinuria, and blood pressure > 130/80 mm Hg. Mean eGFR was lower in Hispanics (39.6 mL/min/1.73 m(2)) than in blacks (43.7 mL/min/1.73 m(2)) and whites (46.2 mL/min/1.73 m(2)), whereas median proteinuria was higher in Hispanics (protein excretion, 0.72 g/d) than in blacks (0.24 g/d) and whites (0.12 g/d; P < 0.01). Limitations: Generalizability; observed associations limited by residual bias and confounding. Conclusions: Hispanics with CKD in the CRIC/H-CRIC Studies are disproportionately burdened with lower socioeconomic status, more frequent diabetes mellitus, less ACE-inhibitor/ARB use, worse blood pressure control, and more severe CKD and associated complications than their non-Hispanic counterparts. Am J Kidney Dis. 58(2): 214-227. Published by Elsevier Inc. on behalf of the National Kidney Foundation, Inc. This is a US Government Work. There are no restrictions on its use.
引用
收藏
页码:214 / 227
页数:14
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