Chronic Kidney Disease and the Risk of End-Stage Renal Disease versus Death
Among older adults with chronic kidney disease (CKD), the comparative event rates of end-stage renal disease (ESRD) and cause-specific death are unknown.
The CHS is a longitudinal cohort study of community-dwelling adults aged 65 years and older.
1,268 participants with an estimated glomerular filtration rate (eGFR) < 60 ml/min per 1.73 m2 were followed until the time of first event (ESRD, cardiovascular or non-cardiovascular death) or until March 31, 2003.
The outcomes were ESRD, cardiovascular- and non-cardiovascular death. Rates of each event were calculated, and a Cox Proportional Hazards Model with a competing risk framework was used to examine risk factors for ESRD as compared with death. Predictors included age, gender, race, BMI, hypertension, diabetes, cardiovascular disease, heart failure, tobacco use, eGFR, and total cholesterol.
During 9.7 years of follow-up, 5% of the cohort progressed to ESRD, and 61% of the cohort died. The rate (per 100 person-years) was 0.5 for ESRD and 6.8 for all-cause mortality (3.0 for cardiovascular and 3.8 for non-cardiovascular mortality). In the competing risk framework, lower eGFR, male gender, African-American race, and higher BMI were associated with an increased risk of ESRD.
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- Chronic Kidney Disease and the Risk of End-Stage Renal Disease versus Death
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Journal of General Internal Medicine
Volume 26, Issue 4 , pp 379-385
- Cover Date
- Print ISSN
- Online ISSN
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- renal disease
- cardiovascular disease
- clinical epidemiology
- Industry Sectors
- Lorien S. Dalrymple MD, MPH (1)
- Ronit Katz DPhil (2)
- Bryan Kestenbaum MD, MS (3)
- Michael G. Shlipak MD, MPH (4) (5)
- Mark J. Sarnak MD, MS (6)
- Catherine Stehman-Breen MD, MS (7)
- Stephen Seliger MD, MS (8)
- David Siscovick MD, MPH (3) (9)
- Anne B. Newman MD, MPH (10) (11)
- Linda Fried MD, MPH (10) (11) (12)
- Author Affiliations
- 1. Department of Medicine, University of California Davis, 4150 V Street, #3500 PSSB, Sacramento, CA, 95817, USA
- 2. Department of Biostatistics, University of Washington, Seattle, WA, USA
- 3. Department of Medicine, University of Washington, Seattle, WA, USA
- 4. General Internal Medicine Section, Medical Service, Veterans Affairs Medical Center, San Francisco, CA, USA
- 5. Department of Medicine, University of California, San Francisco, CA, USA
- 6. Department of Medicine, Tufts Medical Center, Boston, MA, USA
- 7. Amgen Inc., Thousand Oaks, CA, USA
- 8. Department of Medicine, University of Maryland School of Medicine, Baltimore, MD, USA
- 9. Department of Epidemiology, University of Washington, Seattle, WA, USA
- 10. Department of Medicine, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
- 11. Department of Epidemiology, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
- 12. Renal Section, VA Pittsburgh Health Care System, Pittsburgh, PA, USA