TY - JOUR
T1 - Incidence and progression of chronic kidney disease in black and white individuals with type 2 diabetes
AU - Gerber, Claire
AU - Cai, Xuan
AU - Lee, Jungwha
AU - Craven, Timothy
AU - Scialla, Julia
AU - Souma, Nao
AU - Srivastava, Anand
AU - Mehta, Rupal
AU - Paluch, Amanda
AU - Hodakowski, Alexander
AU - Frazier, Rebecca
AU - Carnethon, Mercedes R.
AU - Wolf, Myles Selig
AU - Isakova, Tamara
N1 - Funding Information:
This work was supported by grants R01DK102438 (T.I.), R01DK110087 (T.I.), R01DK081374 (M.S.W.), R01DK076116 (M.S.W.), R01DK094796 (M.S.W.), K24DK093723 (M.S.W.), U01DK099930 (M.S.W. and T.I.), and T32DK007169 (C.G.) from the National Institutes of Health, a Strategically Focused Research Network Center Grant on Health Disparities from the American Heart Association (M.R.C., M.S.W., and T.I.), and a Donald E. Wesson Research Fellowship from the American Society of Nephrology (C.G.). This manuscript was prepared using Action to Control Cardiovascular Risk in Diabetes (ACCORD) trial research materials obtained from the National Heart, Lung, and Blood Institute (NHLBI) Biologic Specimen and Data Repository Information Coordinating Center and does not necessarily reflect the opinions or views of the ACCORD trial or the NHLBI. The funders had no role in the design, analysis, or interpretation of data, preparation and review of the manuscript or in the decision to submit the manuscript for publication.
Funding Information:
This work was supported by grants R01DK102438 (T.I.), R01DK110087 (T.I.), R01DK081374 (M.S.W.), R01DK076116 (M.S.W.), R01DK094796(M.S.W.), K24DK093723 (M.S.W.), U01DK099930(M.S.W. and T.I.), and T32DK007169 (C.G.) from the National Institutes of Health, a Strategically Focused Research Network Center Grant on Health Disparities from the American Heart Association (M.R.C., M.S.W., and T.I.), and a Donald E. Wesson Research Fellowship from the American Society of Nephrology (C.G.).
Funding Information:
T.I. received grant support from Shire. M.S.W. has served as a consultant or received honoraria from Akebia, Amag, Amgen, Arde-lyx, Diasorin, Incyte, Keryx, Luitpold, Pfizer, Sanofi, and Ultragenyx and received grant support from Shire. R.M. has interest in Abbot Laboratories, AbbVie, Inc. and Teva Pharmaceuticals Industries Ltd.
Publisher Copyright:
© 2018 by the American Society of Nephrology.
PY - 2018/6/7
Y1 - 2018/6/7
N2 - Background and objectives Type 2 diabetes and associated CKD disproportionately affect blacks. It is uncertain if racial disparities in type 2 diabetes-associated CKD are driven by biologic factors that influence propensity to CKD or by differences in type 2 diabetes care. Design, setting, participants, & measurements We conducted a post hoc analysis of 1937 black and 6372 white participants of the Action to Control Cardiovascular Risk in Diabetes (ACCORD) trial to examine associations of black race with change in eGFR and risks of developing microalbuminuria, macroalbuminuria, incident CKD (eGFR,60 ml/min per 1.73m2, ≥ 25% decrease frombaseline eGFR, and eGFR slope,21.6 ml/min per 1.73 m2 per year), and kidney failure or serum creatinine >3.3 mg/dl. Results During a median follow-up that ranged between 4.4 and 4.7 years, 278 black participants (58 per 1000 person-years) and 981 white participants (55 per 1000 person-years) developed microalbuminuria, 122 black participants (16 per 1000 person-years) and 374 white participants (14 per 1000 person-years) developed macroalbuminuria, 111 black participants (21 per 1000 person-years) and 499 white participants (28 per 1000 person-years) developed incident CKD, and 59 black participants (seven per 1000 person-years) and 178 white participants (six per 1000 person-years) developed kidney failure or serum creatinine >3.3 mg/dl. Compared with white participants, black participants had lower risks of incident CKD (hazard ratio, 0.73; 95% confidence intervals, 0.57 to 0.92). There were no significant differences by race in eGFR decline or in risks of microalbuminuria, macroalbuminuria, and kidney failure or of serum creatinine >3.3 mg/dl. Conclusions Black participants enrolled in a randomized controlled trial had lower rates of incident CKD compared with white participants. Rates of eGFR decline, microalbuminuria, macroalbuminuria, and kidney failure did not vary by race.
AB - Background and objectives Type 2 diabetes and associated CKD disproportionately affect blacks. It is uncertain if racial disparities in type 2 diabetes-associated CKD are driven by biologic factors that influence propensity to CKD or by differences in type 2 diabetes care. Design, setting, participants, & measurements We conducted a post hoc analysis of 1937 black and 6372 white participants of the Action to Control Cardiovascular Risk in Diabetes (ACCORD) trial to examine associations of black race with change in eGFR and risks of developing microalbuminuria, macroalbuminuria, incident CKD (eGFR,60 ml/min per 1.73m2, ≥ 25% decrease frombaseline eGFR, and eGFR slope,21.6 ml/min per 1.73 m2 per year), and kidney failure or serum creatinine >3.3 mg/dl. Results During a median follow-up that ranged between 4.4 and 4.7 years, 278 black participants (58 per 1000 person-years) and 981 white participants (55 per 1000 person-years) developed microalbuminuria, 122 black participants (16 per 1000 person-years) and 374 white participants (14 per 1000 person-years) developed macroalbuminuria, 111 black participants (21 per 1000 person-years) and 499 white participants (28 per 1000 person-years) developed incident CKD, and 59 black participants (seven per 1000 person-years) and 178 white participants (six per 1000 person-years) developed kidney failure or serum creatinine >3.3 mg/dl. Compared with white participants, black participants had lower risks of incident CKD (hazard ratio, 0.73; 95% confidence intervals, 0.57 to 0.92). There were no significant differences by race in eGFR decline or in risks of microalbuminuria, macroalbuminuria, and kidney failure or of serum creatinine >3.3 mg/dl. Conclusions Black participants enrolled in a randomized controlled trial had lower rates of incident CKD compared with white participants. Rates of eGFR decline, microalbuminuria, macroalbuminuria, and kidney failure did not vary by race.
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U2 - 10.2215/CJN.11871017
DO - 10.2215/CJN.11871017
M3 - Article
C2 - 29798889
AN - SCOPUS:85048302487
VL - 13
SP - 884
EP - 892
JO - Clinical journal of the American Society of Nephrology : CJASN
JF - Clinical journal of the American Society of Nephrology : CJASN
SN - 1555-9041
IS - 6
ER -
