Author contributions: JS, BIF, DWB, and MCYN initiated the study; JS and LW designed and performed the data analysis; XZ, LSH and JX prepared and preprocessed the data; FCH and SHC supervised the statistical analysis; JS and LW prepared the manuscript; BIF and DWB revised the manuscript.All rights reserved. No reuse allowed without permission.was not peer-reviewed) is the author/funder, who has granted bioRxiv a license to display the preprint in perpetuity.The copyright holder for this preprint (which . http://dx.doi.org/10.1101/361956 doi: bioRxiv preprint first posted online Jul. 4, 2018; 2 Abstract Background. Chronic kidney disease (CKD) is a common, complex, and heterogeneous disease impacting aging populations. Determining the landscape of disease progression trajectories from midlife to senior age in a "real-world" context allows us to better understand the progression of CKD, the heterogeneity of progression patterns among the risk population, and the interactions with other clinical conditions. Genetics also plays an important role. In previous work, we and others have demonstrated that African Americans with high-risk APOL1 genotypes are more likely to develop CKD, tend to develop CKD earlier, and the disease progresses faster. Diabetes, which is more common in African Americans, also significantly increases risk for CKD.