Article Figures & Data
Figures
Figure 1. Kaplan-Meier survival analysis for the composite outcome stratified by the presence of chronic kidney disease. Bars represent 95% confidence intervals.
Figure 2. Racial differences in the adjusted 10-yr probability of survival to the composite outcome based on level of GFR. Dashed lines represent 95% confidence intervals.
Tables
Table 1. Baseline characteristics by original study and CKD groupa
Baseline Variables ARIC (n = 12,904) CHS (n = 4,232) FHS (n = 1,950) Offspring (n = 3,548) CKDb (n = 1,664) No CKDb (n = 20,970) Total (n = 22,634) a CKD, chronic kidney disease; ARIC, Atherosclerosis Risk in Communities Study; CHS, Cardiovascular Health Study; FHS, Framingham Heart Study; Offspring, Framingham Offspring Study; BMI, body mass index; LVH, left ventricular hypertrophy. b The P value for all variables between subjects with CKD and those without CKD is <0.05 with the exception of LVH and HDL cholesterol. All values for continuous variables are means ± SD. Demographic data (%) age (yr) 53.9 ± 5.7 72.9 ± 5.4 68.1 ± 7.2 43.9 ± 10.0 68.1 ± 11.4 56.2 ± 11.2 57.1 ± 11.6 male 44.5 38.8 37.6 48.3 33.1 44.2 43.4 black 27.5 14.5 0 0 9.6 19.1 18.4 high school graduate 77.9 72.4 65.5 92.7 70.1 78.8 78.2 Lifestyle (%) smoking, current 25.6 12.4 25.8 36.2 15.7 25.5 24.8 alcohol, current 57.4 51.4 61.6 76.7 52.3 60.2 59.7 Medical history (%) diabetes 9.5 13.7 10.9 3.8 13.9 9.2 9.5 hypertension 36.1 59.9 52.4 21.9 62.1 38.0 39.7 Medication use (%) antihypertensive agents 26.6 38.8 27.9 8.9 45.9 24.7 26.2 lipid-lowering agents 2.4 4.3 2.0 0.6 3.4 2.3 2.4 diabetes agents 4.5 6.7 4.3 1.0 7.1 4.1 4.3 Physical characteristics BMI (kg/m2) 27.5 ± 5.2 26.5 ± 4.1 26.2 ± 4.1 27.7 ± 4.6 26.9 ± 4.5 27.3 ± 4.9 27.2 ± 4.9 systolic BP (mmHg) 121.1 ± 18.6 136.3 ± 21.4 135.6 ± 18.6 122.0 ± 16.3 134.7 ± 22.1 124.6 ± 19.6 125.3 ± 20.0 diastolic BP (mmHg) 73.9 ± 11.2 71.3 ± 11.5 75.9 ± 9.8 78.0 ± 9.7 73.6 ± 11.5 74.3 ± 11.1 74.3 ± 11.1 LVH (%) 4.8 3.4 1.2 0.3 3.4 3.5 3.5 Laboratory values creatinine calibrated (mg/dl) 0.9 ± 0.2 0.9 ± 0.3 0.9 ± 0.3 0.8 ± 0.2 1.3 ± 0.3 0.8 ± 0.2 0.9 ± 0.2 GFR (ml/min per 1.73 m2) 93.3 ± 19.8 79.9 ± 22.0 83.2 ± 28.3 98.7 ± 28.3 51.7 ± 7.6 93.9 ± 21.4 90.8 ± 23.4 total cholesterol (mg/dl) 214 ± 42 212 ± 39 230 ± 41 233 ± 47 224 ± 46 218 ± 43 218 ± 43 HDL cholesterol (mg/dl) 52 ± 17 56 ± 16 51 ± 15 49 ± 13 52 ± 16 52 ± 16 52 ± 16 Table 2. Baseline characteristics and outcomes by race and level of kidney functiona
Baseline Variables GFR Group (ml/min per 1.73 m2) White Black 15–59 (n = 1,505) ≥60 (n = 16,961) 15–59 (n = 159) ≥60 (n = 4,009) a MI, myocardial infarction; CHD, coronary heart disease. All values for continuous variables are means ± SD and for categorical variables are percentages. Demographic data (%) age (yr) 68.2 ± 11.3 56.3 ± 11.7 66.7 ± 11.9 55.8 ± 8.6 male 33.0 45.5 33.3 38.8 high school graduate 71.8 83.3 54.1 59.7 Lifestyle (%) smoking, current 15.0 24.9 22.6 28.0 alcohol, current 55.3 66.4 23.9 34.0 Medical history (%) diabetes 12.4 7.4 28.3 16.7 hypertension 59.4 33.4 88.1 57.2 Medication use (%) antihypertensive agents 42.3 20.7 79.2 41.4 lipid-lowering agents 3.4 2.5 3.7 1.4 diabetes agents 5.5 2.8 22.2 10.0 Physical characteristics BMI (kg/m2) 26.7 ± 4.3 26.8 ± 4.5 29.2 ± 5.7 29.2 ± 5.9 systolic BP (mmHg) 133.9 ± 21.6 123.3 ± 18.9 143.0 ± 25.6 129.3 ± 20.9 diastolic BP (mmHg) 73.0 ± 11.2 73.1 ± 10.5 79.4 ± 12.5 79.4 ± 11.9 LVH (%) 2.6 2.0 11.9 9.2 Laboratory values creatinine calibrated (mg/dl) 1.3 ± 0.3 0.8 ± 0.2 1.6 ± 0.5 0.9 ± 0.2 GFR (ml/min per 1.73 m2) 51.9 ± 7.3 91.9 ± 20.9 49.6 ± 10.0 102.0 ± 21.5 total cholesterol (mg/dl) 225 ± 45 219 ± 42 216 ± 47 214 ± 44 HDL cholesterol (mg/dl) 52 ± 16 52 ± 16 54 ± 18 56 ± 17 Clinical outcomes (%) MI/fatal CHD 9.7 5.5 13.8 4.6 stroke 7.3 2.6 9.4 3.7 all-cause mortality 22.5 7.9 27.7 8.7 Table 3. Outcomes by level of kidney function
GFR15–59 (ml/min per 1.73 m2) GFR≥60 (ml/min per 1.73 m2) a Note that because events may overlap categories, the sum of events is greater than the composite total. MI/fatal CHD % events 10.1% (168/1664) 5.3% (1111/20970) person-years at risk 12,125 169,779 events per 1000 person-years 13.9 6.5 Stroke % events 7.5% (125/1664) 2.8% (587/20970) person-years at risk 12,168 171,470 events per 1000 person-years 10.3 3.4 All-cause mortality % events 23.0% (383/1664) 8.1% (1693/20970) person-years at risk 12,450 172,926 events per 1000 person-years 30.8 9.8 Compositea % events 30.1% (500/1664) 13.2% (2762/20970) person-years at risk 11,887 168,459 events per 1000 person-years 42.1 16.4 Table 4. Hazard ratio for outcomes in patients with CKD in the fully adjusted modela
Outcome Hazard Ratio (95% CI) P Value P Value for Race Interaction a Covariates include age, gender, history of hypertension, history of diabetes, systolic BP, BMI, total and HDL cholesterol, current smoking, current alcohol use, LVH, high school graduation status, and race where applicable. MI/FCHD all 1.09 (0.91 to 1.29) 0.35 0.003 white 1.01 (0.84 to 1.21) 0.94 black 2.09 (1.33 to 3.26) 0.001 Stroke all 1.17 (0.95 to 1.44) 0.13 0.90 white 1.17 (0.94 to 1.45) 0.17 black 1.21 (0.71 to 2.08) 0.48 MI/FCHD/stroke all 1.10 (0.95 to 1.26) 0.20 0.004 white 1.03 (0.89 to 1.19) 0.70 black 1.78 (1.25 to 2.54) 0.001 All-cause mortality all 1.36 (1.21 to 1.53) <0.001 0.053 white 1.31 (1.16 to 1.49) <0.001 black 1.83 (1.33 to 2.52) <0.001 Composite all 1.19 (1.07 to 1.32) 0.001 0.002 white 1.13 (1.02 to 1.26) 0.02 black 1.76 (1.35 to 2.31) <0.001
Chronic Kidney Disease as a Risk Factor for Cardiovascular Disease and All-Cause Mortality: A Pooled Analysis of Community-Based Studies
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