Background
Methods
Study sample
Measurements
Causes of death
Statistical analysis
Reclassification
Results
Baseline characteristics
EGFRMDRD
| ≥120 | 90-119 | 60-89 | 30-59 | <30 | |||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|
(No. of participants)a
| (2,729) | (6,604) | (5,606) | (1,015) | (56) | |||||||
EGFRCKD-EPI
| ≥120 | 90-119 | ≥120 | 90-119 | 60-89 | 90-119 | 60-89 | 30-59 | 60-89 | 30-59 | <30 | <30 |
Number of participants a (%) b
| 2,416 | 312 d
| 1,473 | 4,969 | 162 | 1,870 | 3,664 | 72 | 120 | 883 | 12 | 55 e
|
(88.3) | (11.7) | (20.2) | (78.4) | (1.4) | (42.9) | (56.6) | (0.5) | (19.4) | (79.5) | (1.1) | (99.5) | |
Characteristic
c
| ||||||||||||
Serum Creatinine (mg/dl) | 0.64 | 0.59 | 0.76 | 0.79 | 0.70 | 0.87 | 0.94 | 1.07 | 1.07 | 1.26 | 1.97 | 2.76 |
(0.004) | (0.01) | (0.003) | (0.002) | (0.01) | (0.004) | (0.004) | (0.03) | (0.02) | (0.02) | (0.11) | (0.20) | |
EGFRMDRD (ml/min/1.73 m2) | 138 | 131 | 112 | 100 | 98 | 85 | 74 | 61 | 58 | 49 | 31 | 23 |
(0.63) | (0.72) | (0.17) | (0.18) | (0.28) | (0.09) | (0.13) | (0.09) | (0.13) | (0.27) | (0.32) | (0.88) | |
EGFRCKD-EPI (ml/min/1.73 m2) | 133 | 112 | 124 | 109 | 87 | 96 | 79 | 59 | 63 | 50 | 29 | 22 |
(0.36) | (0.51) | (0.14) | (0.12) | (0.27) | (0.18) | (0.20) | (0.13) | (0.20) | (0.30) | (0.24) | (0.92) | |
Age (years) | 26 (0.2) | 53 (0.8) | 28 (0.3) | 39 (0.2) | 79 (0.5) | 40 (0.5) | 59 (0.6) | 83 (1.0) | 56 (1.11) | 72 (0.74) | 81 (2.12) | 72 (1.75) |
Age < 65 years, N (%) a b
| 2,415 | 247 | 1,473 | 4,614 | 0 | 1,754 | 1,717 | 0 | 100 | 115 | 0 | 12 |
(99.9) | (85.8) | (100) | (96.4) | (95.8) | (61.3) | (83.8) | (18.0) | (16.9) | ||||
Male (%) | 40 | 55 | 44 | 53 | 56 | 46 | 49 | 60 | 24 | 40 | 72 | 35 |
Race/Ethnicity (%) | ||||||||||||
Non-Hispanic White | 52 | 67 | 65 | 74 | 85 | 86 | 86 | 86 | 90 | 86 | 90 | 73 |
Non-Hispanic Black | 25 | 9 | 19 | 11 | 7 | 4 | 7 | 13 | 1 | 8 | 9 | 18 |
Mexican American | 13 | 10 | 8 | 6 | 2 | 4 | 2 | 1 | 2 | 1 | 1 | 2 |
Other | 11 | 13 | 9 | 10 | 7 | 6 | 6 | 1 | 6 | 5 | 0 | 8 |
Ever or Current Smoker (%) | 45 | 68 | 46 | 56 | 47 | 51 | 54 | 43 | 57 | 55 | 84 | 56 |
Diabetes (%) | 3 | 13 | <1 | 3 | 11 | 3 | 8 | 6 | 14 | 15 | 27 | 26 |
Prior CVD (%) | <1 | <1 | <1 | 3 | 16 | 3 | 10 | 22 | 13 | 26 | 73 | 35 |
Body Mass Index (kg/m2) | 25 | 27 | 25 | 26 | 25 | 26 | 27 | 25 | 29 | 28 | 25 | 26 |
(0.23) | (0.75) | (0.20) | (0.14) | (0.26) | (0.20) | (0.15) | (0.45) | (0.68) | (0.24) | (1.02) | (1.18) | |
Systolic Blood Pressure, mm Hg | 112 | 130 | 112 | 119 | 145 | 118 | 131 | 143 | 130 | 143 | 150 | 145 |
(0.46) | (1.90) | (0.34) | (0.31) | (1.86) | (0.45) | (0.59) | (1.99) | (2.22) | (1.03) | (6.01) | (3.66) | |
Diastolic Blood Pressure, mm Hg | 68 | 78 | 69 | 74 | 73 | 75 | 76 | 72 | 76 | 75 | 71 | 73 |
(0.41) | (0.95) | (0.35) | (0.28) | (1.05) | (0.32) | (0.25) | (1.14) | (0.85) | (0.49) | (2.11) | (2.98) | |
Antihypertensive medication use (%) | 4 | 26 | 2 | 10 | 32 | 10 | 27 | 44 | 36 | 60 | 75 | 74 |
Total Cholesterol (mg/dl) | 183 | 217 | 181 | 198 | 208 | 204 | 217 | 213 | 230 | 232 | 209 | 230 |
(1.69) | (4.92) | (1.68) | (1.14) | (3.82) | (1.57) | (1.21) | (5.49) | (4.65) | (2.81) | (10.31) | (14.24) | |
CRP (mg/dl; %) | ||||||||||||
<0.22 | 73 | 58 | 80 | 75 | 71 | 76 | 67 | 62 | 64 | 52 | 29 | 42 |
0.22-0.99 | 19 | 29 | 14 | 19 | 22 | 19 | 25 | 28 | 23 | 32 | 12 | 40 |
≥1.00 | 9 | 13 | 6 | 6 | 7 | 5 | 8 | 10 | 13 | 16 | 59 | 18 |
ACR (mg/g; %) | ||||||||||||
<30 | 93 | 84 | 93 | 94 | 74 | 95 | 89 | 78 | 83 | 70 | 9 | 34 |
30-300 | 6 | 11 | 7 | 5 | 25 | 5 | 10 | 18 | 15 | 23 | 68 | 20 |
≥300 | <1 | 5 | <1 | <1 | 17 | 1 | 1 | 4 | 3 | 7 | 23 | 46 |
Estimated GFR and the risk of death
Categories of eGFR (ml/min/1.73 m2) | ||||||
---|---|---|---|---|---|---|
≥ 120 | 90-119 | 60-89 | 30-59 | < 30 | ||
All-Cause Mortality | ||||||
EGFR
CKD-EPI
| Participants, N | 3,889 | 7,151 | 3,947 | 956 | 67 |
Deaths, N | 179 | 921 | 1,686 | 775 | 59 | |
HR | 2.05 | Reference | 0.97 | 1.39 | 1.38 | |
(95% CI) | (1.55-2.71) | (0.86-1.10) | (1.17-1.65) | (0.88-2.16) | ||
EGFR
MDRD
| Participants, N | 2,729 | 6,604 | 5,606 | 1,015 | 56 |
Deaths, N | 228 | 805 | 1,788 | 750 | 49 | |
HR | 1.70 | Reference | 0.94 | 1.31 | 1.96 | |
(95% CI) | (1.36-2.14) | (0.84-1.05) | (1.11-1.56) | (1.11-3.44) | ||
CVD Mortality
| ||||||
EGFR
CKD-EPI
| Participants, N | 3,889 | 7,151 | 3,947 | 956 | 67 |
Deaths, N | 41 | 303 | 755 | 412 | 29 | |
HR | 2.70 | Reference | 1.05 | 1.49 | 1.64 | |
(95% CI) | (1.54-4.73) | (0.87-1.26) | (1.16-1.92) | (1.02-2.65) | ||
EGFR
MDRD
| Participants, N | 2,729 | 6,604 | 5,606 | 1,015 | 56 |
Deaths, N | 64 | 278 | 774 | 401 | 23 | |
HR | 1.53 | Reference | 0.95 | 1.32 | 2.17 | |
(95% CI) | (0.96-2.45) | (0.79-1.13) | (0.99-1.78) | (1.18-3.98) |
Reclassification by eGFRCKD-EPI and the risk of death
EGFRCKD-EPICategories | |||||
---|---|---|---|---|---|
EGFR
MDRD
Categories
| >120 | 90-119 | 60-89 | 30-59 | <30 |
>120
| |||||
Reclassified, N b (%)c
| 2,416 (88.3) | 312 (11.7) | |||
All-Cause Mortality
| |||||
Deaths, N b
| 126 | 101 | |||
HR (95% CI) | REFERENCE | 0.57 (0.26-1.26) | |||
CVD Mortality
| |||||
Deaths b
| 28 | 36 | |||
HR (95% CI) | REFERENCE | 0.37 (0.15-0.94) | |||
90-119
| |||||
Reclassified, N b (%)c
| 1,473 (20.2) | 4,969 (78.4) | 162 (1.4) | ||
All-Cause Mortality
| |||||
Deaths, N b
| 53 | 604 | 148 | ||
HR (95% CI) | 1.42 (0.85-2.37) | REFERENCE | 1.39 (0.94-2.07) | ||
CVD Mortality
| |||||
Deaths b
| 13 | 193 | 72 | ||
HR (95% CI) | 2.95 (1.03-8.42) | REFERENCE | 1.79 (0.94-3.39) | ||
60-89
| |||||
Reclassified, N b (%)c
| 1,870 (42.9) | 3,664 (56.6) | 72 (0.5) | ||
All-Cause Mortality
| |||||
Deaths, N b
| 216 | 1,506 | 66 | ||
HR (95% CI) | 1.13 (0.91-1.42) | REFERENCE | 1.31 (1.01-1.69) | ||
CVD Mortality
| |||||
Deaths b
| 74 | 669 | 31 | ||
HR (95% CI) | 1.02 (0.69-1.50) | REFERENCE | 1.42 (1.01-1.99) | ||
30-59
| |||||
Reclassified, N b (%)c
| 120 (19.4) | 883 (79.5) | 12 (1.1) d
| ||
All-Cause Mortality
| |||||
Deaths, N b
| 31 | 708 | 11 | ||
HR (95% CI) | 0.53 (0.34-0.84) | REFERENCE | N/A | ||
CVD Mortality
| |||||
Deaths b
| 14 | 381 | 6 | ||
HR (95% CI) | 0.51(0.27-0.96) | REFERENCE | N/A |
Net reclassification improvement by eGFRCKD-EPI
Reclassification, number (Population %)a
| Deaths, | NRI | ||
---|---|---|---|---|
All-cause (CVD) | All-cause | CVD | ||
Overall
| 11,808 (24.1%) | 3,339 (1,463) | 0.2073*** | 0.2216*** |
By Age Categories
| ||||
17-44 | 4,822 (30.3%) | 208 (58) | 0.0216 | −0.0883 |
45-64 | 3,491 (21.8%) | 715 (258) | −0.0146 | −0.0006 |
≥65 | 3,495 (11.4%) | 2,416 (1,147) | 0.1362*** | 0.0943*** |
By Sex
| ||||
Male | 5,839 (22.1%) | 1,844 (796) | 0.2077*** | 0.2277*** |
Females | 5,969 (26.0%) | 1,495 (667) | 0.2063*** | 0.2157*** |
By Race/Ethnicity
| ||||
NH Whites | 5,736 (25.7%) | 1,957 (903) | 0.2258*** | 0.2368*** |
NH Blacks | 2,701 (12.8%) | 710 (290) | 0.1245*** | 0.1229*** |
Mex-Am | 2,868 (20.2%) | 594 (239) | 0.0648** | 0.0682* |
Others | 503 (20.2%) | 78 (31) | 0.1427* | 0.2559*** b
|