Original Investigation
Pathogenesis and Treatment of Kidney Disease
Prevalence and Awareness of CKD Among African Americans: The Jackson Heart Study

https://doi.org/10.1053/j.ajkd.2008.08.035Get rights and content

Background

Chronic kidney disease (CKD) leads to end-stage renal disease and is a growing epidemic throughout the world. In the United States, African Americans have an incidence of end-stage renal disease 4 times that of whites.

Study Design

Cross-sectional to examine the prevalence and awareness of CKD in African Americans.

Setting & Participants

Observational cohort in the Jackson Heart Study (JHS).

Predictor

CKD was defined as an estimated glomerular filtration rate less than 60 mL/min/1.73 m2, the presence of albuminuria, or dialysis therapy.

Outcomes & Measurements

Data from the JHS were analyzed. Medical history, including disease awareness and drug therapy, anthropometric measurements, and serum and urine samples, were obtained from JHS participants at the baseline visit. Associations between CKD prevalence and awareness and selected demographic, socioeconomic, health care access, and disease status parameters were assessed by using logistic regression models.

Results

The prevalence of CKD in the JHS was 20%; CKD awareness was only 15.8%. Older participants had a greater prevalence, but also were more aware of CKD. Hypertension, diabetes, cardiovascular disease, hypercholesterolemia, hypertriglyceridemia, increasing age and waist circumference, and being single or less physically active were associated with CKD. Only advancing CKD stage was associated with awareness.

Limitations

Cross-sectional assessment, single urine measurement.

Conclusions

The JHS has a high prevalence and low awareness of CKD, especially in those with less severe disease status. This emphasizes the need for earlier diagnosis and increased education of health care providers and the general population.

Section snippets

Study Design, Participants, and Measurements

The JHS is a single-site longitudinal population-based study designed to prospectively explore the determinants (both individual and environmental) and genetic linkages that influence the development of CVD in African Americans. The sample consists of 5,302 women and men selected between 2000 and 2004 from a tricounty area of Mississippi: Hinds, Madison, and Rankin counties. The rationale for the study stems from the large disparity in cardiovascular mortality between Mississippi African

Descriptive Data

After excluding participants with restricted consent (n = 23) or without sufficient serum (n = 56) or urine data (n = 1,792) to determine CKD status, 3,431 participants (2,154 women and 1,277 men) were used in these analyses. Of the included participants, 1,015 had 24-hour and 2,255 had spot urine collections; an additional 161 participants with missing urine data were classified as having CKD because of low eGFR or being on dialysis therapy. Table 1 lists baseline characteristics of the JHS by

Discussion

The findings of this cross-sectional cohort of African American adults enrolled in the JHS further confirm the increasing national epidemic of CKD, particularly in non-Hispanic African Americans, with prevalence estimates similar to the most current national estimates of 16.8% for the entire population reported by the Centers for Disease Control and Prevention from analyses of the 1999 to 2004 NHANES data.4 Older participants (≥60 years) in both the NHANES (39.4%) and JHS (31.7%) had a greater

Acknowledgements

Support: This study was funded by the National Heart, Lung, and Blood Institute, National Institutes of Health.

Financial Disclosure: None.

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