Original InvestigationPathogenesis and Treatment of Kidney DiseaseTrajectories of Kidney Function Decline in Young Black and White Adults With Preserved GFR: Results From the Coronary Artery Risk Development in Young Adults (CARDIA) Study
Section snippets
Participants
We included participants from the CARDIA Study. CARDIA is a prospective cohort study sponsored by the National Heart, Lung and Blood Institute designed to study early determinants of cardiovascular disease. Detailed methods for CARDIA have been published previously.12 Briefly, CARDIA recruited 5,115 black and white persons aged 18-30 years between 1985 and 1986 from 4 sites in the United States (Birmingham, AL; Chicago, IL; Minneapolis, MN; and Oakland, CA). After the first examination,
Cohort Characteristics
For the 3,348 CARDIA participants included in this study, mean age at baseline (CARDIA year 10) was 35 ± 3.6 (SD) years, 288 (9%) had hypertension, and 225 (7%) had diabetes. Blacks were more likely to have diabetes, hypertension, and a higher prevalence of albuminuria. eGFRcys at baseline was ∼6 mL/min/1.73 m2 higher for blacks compared with whites (Table 1).
Trajectories of eGFRcys Decline by Race
In Fig 1, we present the trajectories of adjusted mean eGFRcys as a function of age for blacks and whites separately. Each point on the
Discussion
In this large cohort of young black and white persons with largely preserved kidney function, we found that on average, decline in eGFR is minimal prior to age 35 years, and that rates of decline accelerate at older ages. However, we found important racial differences in these kidney function trajectories. Specifically, prior to age 35, eGFRcys decline was fairly similar by race. After age 35, eGFRcys decline was significantly steeper for blacks compared with whites, and this decline started at
Acknowledgements
Support: Dr Peralta is funded by grant 1K23DK082793-01 from the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) and the Robert Wood Johnson Harold Amos Program. Dr Bibbins-Domingo was in part supported by grant R01DK078124 from the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), grant N01HC48050 from the National Heart, Lung and Blood Institute (NHLBI), from grant 1P60MD006902 from the National Institute on Minority Health and Health Disparities
References (17)
- et al.
Estimating GFR using serum cystatin C alone and in combination with serum creatinine: a pooled analysis of 3,418 individuals with CKD
Am J Kidney Dis
(2008) - et al.
CARDIA: study design, recruitment, and some characteristics of the examined subjects
J Clin Epidemiol
(1988) - et al.
Prevalence of chronic kidney disease in the United States
JAMA
(2007) - et al.
Racial differences in the progression from chronic renal insufficiency to end-stage renal disease in the United States
J Am Soc Nephrol
(2003) - et al.
Racial differences in the incidence of chronic kidney disease
Clin J Am Soc Nephrol
(2012) - et al.
Racial and ethnic differences in kidney function decline among persons without chronic kidney disease
J Am Soc Nephrol
(2011) - et al.
Longitudinal studies on the rate of decline in renal function with age
J Am Geriatr Soc
(1985) - et al.
Assessing kidney function—measured and estimated glomerular filtration rate
N Engl J Med
(2006)
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Originally published online March 8, 2013.