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

Fischer, Michael J.; Go, Alan S.; Lora, Claudia M.; Ackerson, Lynn; Cohan, Janet; Kusek, John W.; Mercado, Alejandro; Ojo, Akinlolu; Ricardo, Ana C.; Rosen, Liana W.; Tao, Kaixiang; Xie, Dawei; Feldman, Harold I.; Lash, James P.

doi:10.1053/j.ajkd.2011.05.010

Cited by 109 publications

(113 citation statements)

References 39 publications

Supporting

Mentioning

108

Contrasting

Unclassified

Order By: Relevance

“…Major eligibility criteria for the CRIC Study included adults ages 21-74 years old with mild to moderate CKD using age-based eGFR on the basis of the fourvariable Modification of Diet in Renal Disease estimating equation (15). Aside from recruiting only participants of Hispanic ethnicity, the H-CRIC Study adopted eligibility and exclusion criteria identical to the CRIC Study (16 (17). Participants from the CRIC and H-CRIC Studies comprise the cohort for these analyses.…”

Section: Methodsmentioning

confidence: 99%

Predictors and Outcomes of Health–Related Quality of Life in Adults with CKD

Porter¹,

Lash²,

Xie³

et al. 2016

CJASN

Self Cite

121

130

View full text Add to dashboard Cite

Background and objectives Low health-related quality of life is associated with increased mortality in patients with ESRD. However, little is known about demographic and clinical factors associated with health-related quality of life or its effect on outcomes in adults with CKD.Design, settings, participants, & measurements Data from 3837 adult participants with mild to severe CKD enrolled in the prospective observational Chronic Renal Insufficiency Cohort and Hispanic Chronic Renal Insufficiency Cohort Studies were analyzed. Health-related quality of life was assessed at baseline with the Kidney Disease Quality of Life-36 and its five subscales: mental component summary, physical component summary, burden of kidney disease (burden), effects of kidney disease (effects), and symptoms and problems of kidney disease (symptoms). Low health-related quality of life was defined as baseline score .1 SD below the mean. Using Cox proportional hazards analysis, the relationships between low health-related quality of life and the following outcomes were examined: (1) CKD progression (50% eGFR loss or incident ESRD), (2) incident cardiovascular events, and (3) all-cause death.Results Younger age, women, low education, diabetes, vascular disease, congestive heart failure, obesity, and lower eGFR were associated with low baseline health-related quality of life (P,0.05). During a median follow-up of 6.2 years, there were 1055 CKD progression events, 841 cardiovascular events, and 694 deaths. Significantly higher crude rates of CKD progression, incident cardiovascular events, and all-cause death were observed among participants with low health-related quality of life in all subscales (P,0.05). In fully adjusted models, low physical component summary, effects, and symptoms subscales were independently associated with a higher risk of incident cardiovascular events and death, whereas low mental component summary was independently associated with a higher risk of death (P,0.05). Low health-related quality of life was not associated with CKD progression.Conclusions Low health-related quality of life across several subscales was independently associated with a higher risk of incident cardiovascular events and death but not associated with CKD progression.

show abstract

Section: Methodsmentioning

confidence: 99%

Predictors and Outcomes of Health–Related Quality of Life in Adults with CKD

Porter¹,

Lash²,

Xie³

et al. 2016

CJASN

Self Cite

121

130

View full text Add to dashboard Cite

show abstract

“…Adult participants (n=3612) age 21-74 years with an age-stratified estimated GFR (eGFR) of 20-70 ml/min per 1.73 m 2 at the screening visit were enrolled. To have adequate representation of ethnic minorities, blacks were oversampled, and the ancillary Hispanic CRIC (HCRIC) study enrolled 327 additional Hispanic participants (15). Participants were excluded for pregnancy, New York Heart Association class III-IV heart failure, HIV infection, cirrhosis, myeloma, renal cancer, recent chemotherapy or immunosuppressive therapy, polycystic kidney disease, organ transplantation, or previous treatment with dialysis for at least 1 month.…”

Section: Description Of the Cohortmentioning

confidence: 99%

Fibroblast Growth Factor 23 and Inflammation in CKD

Mendoza

Isakova²,

Ricardo³

et al. 2012

Clinical Journal of the American Society of Nephrology

Self Cite

239

171

View full text Add to dashboard Cite

SummaryBackground and objectives Levels of fibroblast growth factor 23 (FGF23) and inflammatory markers are commonly elevated in CKD, and each is associated with adverse clinical outcomes. This study tested the hypothesis that FGF23 is independently associated with inflammation in CKD.Design, setting, participants, & measurements The association between levels of FGF23 and the inflammatory markers IL-6, C-reactive protein (CRP), TNF-a, and fibrinogen was assessed in a cross-sectional analysis of 3879 participants enrolled in the Chronic Renal Insufficiency Cohort (CRIC) study between June 2003 and September 2008.Results FGF23 correlated directly with IL-6 (r=0.4), CRP (r=0.2), TNF-a (r=0.4), and fibrinogen (r=0.3; P,0.001 for each). In univariate and multivariable-adjusted linear regression analyses, natural log (ln) transformed FGF23 was significantly associated with lnIL-6, lnCRP, lnTNF-a, and fibrinogen (P,0.001 for each). Each unit higher lnFGF23 was associated with severe inflammation, defined as levels of all inflammatory markers in the highest 25th percentile, in univariate (odds ratio [OR], 2.4 [95% confidence interval (CI), 2.0-2.9]) and multivariable-adjusted (OR, 2.0 [95% CI, 1.6-2.5]) logistic regression analyses. Ascending FGF23 quartiles were independently associated with severe inflammation (OR, 5.6 for the highest versus lowest FGF23 quartile [95% CI, 2.3-13.9]; P for trend , 0.001).Conclusions Higher FGF23 levels are independently associated with higher levels of inflammatory markers in patients with CKD and with significantly greater odds of severe inflammation. Future studies should evaluate whether inflammation modifies the association between FGF23 and adverse outcomes in CKD.

show abstract

“…[15][16][17] The CRIC Study recruited 3939 adults from May 2003 to June 2008, aged 21-74 years, with mild to moderate CKD from general medicine and specialty clinics at seven clinical centers across the U.S. (Ann Arbor, Michigan; Baltimore, Maryland; Chicago, Illinois; Cleveland, Ohio; New Orleans, Louisiana; Philadelphia, Pennsylvania; and Oakland, California). Participants were followed with annual in-clinic visits and interim telephone contact.…”

Section: Study Populationmentioning

confidence: 99%

“…Exclusion criteria included inability to consent, institutionalization, pregnancy, and certain chronic conditions. [15][16][17] The study protocol was approved by Institutional Review Boards of participating centers and is in accordance with the principles of the Declaration of Helsinki. All study participants provided written informed consent.…”

Section: Study Populationmentioning

confidence: 99%

See 1 more Smart Citation

Influence of Nephrologist Care on Management and Outcomes in Adults with Chronic Kidney Disease

et al. 2015

Self Cite

View full text Add to dashboard Cite

BACKGROUND: Predialysis nephrology care for adults with late stage chronic kidney disease (CKD) is associated with improved outcomes. Less is known about the effects of nephrology care in earlier stages of CKD. OBJECTIVE: We aimed to evaluate the effect of nephrology care on management of CKD risk factors and complications, CKD progression, incident cardiovascular disease (CVD), and death. DESIGN: This was a prospective cohort study. PARTICIPANTS: Participants included 3855 men and women aged 21 to 74 years enrolled in the Chronic Renal Insufficiency Cohort (CRIC) Study with a mean (SD) estimated glomerular filtration rate (eGFR) at entry of 45 (17) ml/min/1.73 m 2 , followed for a median of 6.6 years. MAIN MEASURES: The main predictor was self-reported prior contact with a nephrologist at study enrollment. Outcomes evaluated included CKD progression (≥ 50 % eGFR loss or end-stage renal disease), incident CVD, and death. RESULTS: Two-thirds (67 %) of the participants reported prior contact with a nephrologist at study enrollment. They were younger, more likely to be male, non-Hispanic white, and had lower eGFR and higher urine protein (p < 0.05). A subgroup with eGFR 30-< 60 ml/min/1.73 m 2 and prior contact with a nephrologist were more likely to receive pharmacologic treatment for CKD-related complications and to report angiotensin-converting enzyme inhibitor or angiotensin receptor blocker (ACEi/ARB) use. After propensity score matching (for reporting prior contact with a nephrologist vs. not) and adjusting for demographic and clinical variables, prior contact with a nephrologist was not significantly associated with CKD progression, incident CVD or death (p > 0.05). CONCLUSIONS: One-third of CRIC participants had not seen a nephrologist before enrollment, and this prior contact was subject to age, sex, and ethnic-related disparities. While prior nephrology care was associated with more frequent treatment of CKD complications and use of ACEi/ARB medications, there was neither an association between this care and achievement of guidelinerecommended intermediate measures, nor long-term adverse outcomes.

show abstract

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

Cited by 109 publications

References 39 publications

Predictors and Outcomes of Health–Related Quality of Life in Adults with CKD

Predictors and Outcomes of Health–Related Quality of Life in Adults with CKD

Fibroblast Growth Factor 23 and Inflammation in CKD

Influence of Nephrologist Care on Management and Outcomes in Adults with Chronic Kidney Disease

Contact Info

Product

Resources

About