Journal article
Albuminuria and Racial Disparities in the Risk for ESRD
Journal of the American Society of Nephrology, v 22(9), pp 1721-1728
01 Sep 2011
PMID: 21868498
Featured in Collection : UN Sustainable Development Goals @ Drexel
Abstract
The causes of the increased risk for ESRD among African Americans are not completely understood. Here, we examined whether higher levels of urinary albumin excretion among African Americans contributes to this disparity. We analyzed data from 27,911 participants in the Reasons for Geographic and Racial Differences in Stroke (REGARDS) study who had urinary albumin-to-creatinine ratio (ACR) and estimated GFR (eGFR) measured at baseline. We identified incident cases of ESRD through linkage with the United States Renal Data System. At baseline, African Americans were less likely to have an eGFR <60 ml/min per 1.73 m
2
but more likely to have an ACR ≥30 mg/g. The incidence rates of ESRD among African Americans and whites were 204 and 58.6 cases per 100,000 person-years, respectively. After adjustment for age and gender, African Americans had a fourfold greater risk for developing ESRD (HR 4.0; 95% CI 2.8 to 5.9) compared with whites. Additional adjustment for either eGFR or ACR reduced the risk associated with African-American race to 2.3-fold (95% CI 1.5 to 3.3) or 1.8-fold (95% CI 1.2 to 2.7), respectively. Adjustment for both ACR and eGFR reduced the race-associated risk to 1.6-fold (95% CI 1.1 to 2.4). Finally, in a model that further adjusted for both eGFR and ACR, hypertension, diabetes, family income, and educational status, African-American race associated with a nonsignificant 1.4-fold (95% CI 0.9 to 2.3) higher risk for ESRD. In conclusion, the increased prevalence of albuminuria may be an important contributor to the higher risk for ESRD experienced by African Americans.
Metrics
Details
- Title
- Albuminuria and Racial Disparities in the Risk for ESRD
- Creators
- William M. McClellan - Emory UniversityDavid G. Warnock - Division of Nephrology, Department of MedicineSuzanne Judd - Departments of Biostatistics andPaul Muntner - Epidemiology, School of Public Health, University of Alabama at Birmingham, Birmingham, AlabamaReshma Kewalramani - Amgen Corporation, Thousand Oaks, CaliforniaMary CushmanLeslie A. McClure - Departments of Biostatistics andBritt B. Newsome - Denver Nephrologists, P.C., Denver, ColoradoGeorge Howard - Departments of Biostatistics and
- Publication Details
- Journal of the American Society of Nephrology, v 22(9), pp 1721-1728
- Publisher
- American Society of Nephrology
- Resource Type
- Journal article
- Language
- English
- Academic Unit
- Epidemiology and Biostatistics
- Web of Science ID
- WOS:000295705800019
- Scopus ID
- 2-s2.0-80052325135
- Other Identifier
- 991019231754004721
UN Sustainable Development Goals (SDGs)
This publication has contributed to the advancement of the following goals:
InCites Highlights
Data related to this publication, from InCites Benchmarking & Analytics tool:
- Collaboration types
- Industry collaboration
- Domestic collaboration
- Web of Science research areas
- Urology & Nephrology