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Incident Chronic Kidney Disease Risk among Hispanics/Latinos in the United States: The Hispanic Community Health Study/Study of Latinos (HCHS/SOL).

TitleIncident Chronic Kidney Disease Risk among Hispanics/Latinos in the United States: The Hispanic Community Health Study/Study of Latinos (HCHS/SOL).
Publication TypePublication
Year2020
AuthorsRicardo AC, Loop MShane, Gonzalez F, Lora CM, Chen J, Franceschini N, Kramer HJ, Toth-Manikowski SM, Talavera GA, Daviglus M, Lash JP
JournalJ Am Soc Nephrol
Volume31
Issue6
Pagination1315-1324
Date Published2020 06
ISSN1533-3450
KeywordsAdult, Female, Glycated Hemoglobin A, Hispanic Americans, Humans, Male, Middle Aged, Public Health, Renal Insufficiency, Chronic, Risk Factors, United States
Abstract

BACKGROUND: Although Hispanics/Latinos in the United States are often considered a single ethnic group, they represent a heterogenous mixture of ancestries who can self-identify as any race defined by the U.S. Census. They have higher ESKD incidence compared with non-Hispanics, but little is known about the CKD incidence in this population.METHODS: We examined rates and risk factors of new-onset CKD using data from 8774 adults in the Hispanic Community Health Study/Study of Latinos. Incident CKD was defined as eGFR <60 ml/min per 1.73 m with eGFR decline ≥1 ml/min per 1.73 m per year, or urine albumin/creatinine ratio ≥30 mg/g. Rates and incidence rate ratios were estimated using Poisson regression with robust variance while accounting for the study's complex design.RESULTS: Mean age was 40.3 years at baseline and 51.6% were women. In 5.9 years of follow-up, 648 participants developed CKD (10.6 per 1000 person-years). The age- and sex-adjusted incidence rates ranged from 6.6 (other Hispanic/mixed background) to 15.0 (Puerto Ricans) per 1000 person-years. Compared with Mexican background, Puerto Rican background was associated with 79% increased risk for incident CKD (incidence rate ratios, 1.79; 95% confidence interval, 1.33 to 2.40), which was accounted for by differences in sociodemographics, acculturation, and clinical characteristics. In multivariable regression analysis, predictors of incident CKD included BP >140/90 mm Hg, higher glycated hemoglobin, lower baseline eGFR, and higher baseline urine albumin/creatinine ratio.CONCLUSIONS: CKD incidence varies by Hispanic/Latino heritage and this disparity may be in part attributed to differences in sociodemographic characteristics. Culturally tailored public heath interventions focusing on the prevention and control of risk factors might ameliorate the CKD burden in this population.

DOI10.1681/ASN.2019101008
Alternate JournalJ Am Soc Nephrol
PubMed ID32300066
PubMed Central IDPMC7269353
Grant ListK24 DK092290 / DK / NIDDK NIH HHS / United States
R21 HL140385 / HL / NHLBI NIH HHS / United States
N01 HC065237 / HC / NHLBI NIH HHS / United States
N01HC65235 / HL / NHLBI NIH HHS / United States
R01 MD012765 / MD / NIMHD NIH HHS / United States
P30 ES010126 / ES / NIEHS NIH HHS / United States
N01HC65236 / HL / NHLBI NIH HHS / United States
N01HC65237 / HL / NHLBI NIH HHS / United States
R01 DK117445 / DK / NIDDK NIH HHS / United States
N01HC65234 / HL / NHLBI NIH HHS / United States
N01HC65233 / HL / NHLBI NIH HHS / United States
R01 DK118736 / DK / NIDDK NIH HHS / United States
MS#: 
0545
Manuscript Lead/Corresponding Author Affiliation: 
Field Center: Chicago (University of Illinois at Chicago)
ECI: 
Manuscript Status: 
Published