Racial and Ethnic Differences in Kidney Function Decline among Persons without Chronic Kidney Disease

Peralta, Carmen A.; Katz, Ronit; DeBoer, Ian; Ix, Joachim H.; Sarnak, Mark J.; Kramer, Holly; Siscovick, David S.; Shea, Steven; Szklo, Moysés; Shlipak, Michael G.

doi:10.1681/asn.2010090960

Cited by 120 publications

(111 citation statements)

References 31 publications

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“…As the burden of advanced CKD is disproportionately higher for blacks and Hispanics in the United States, failure to account for these differences is of particular concern. [28,29] There is a strong direct relation between FMI and ALMI in the general population with correlation coefficients exceeding 0.50 independent of age, sex and race/ethnicity. [5] Therefore, conventional definitions of sarcopenia based on lean mass alone may fail to capture low lean mass relative to fat mass among persons with higher fat mass, i.e., relative sarcopenia.…”

Section: Discussionmentioning

confidence: 99%

Sarcopenia, Relative Sarcopenia and Excess Adiposity in Chronic Kidney Disease

Ziolkowski

Long

Baker

et al. 2018

JCSM Clinical Reports

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Aims Conventional definitions of sarcopenia based on lean mass fail to capture low lean mass relative to fat mass, i.e., relative sarcopenia. Unlike percent body fat (%BF) and Quételet's (body mass) index (BMI, kg/m 2 ), definitions of obesity based on fat mass index (FMI, kg/m 2 ) are not confounded by lean mass. The objective is to determine the prevalence of sarcopenia, relative sarcopenia, and obesity in CKD, and determine if CKD is associated with relative sarcopenia and obesity, independent of demographics and comorbidities.Methods and Results DXA-derived appendicular lean mass index (ALMI, kg/m 2 ) and FMI were assessed in 13,980 NHANES participants. ALMI, FMI, and ALMI relative to FMI (ALMI FMI ) were expressed as sex-and race/ethnicity-specific standard deviation scores compared with young adults (T-scores) and by age (Z-scores). Sarcopenia was defined as ALMI T-score < -2, relative sarcopenia as ALMI FMI T-score < -2, and low lean mass relative to fat mass for age as ALMI FMI Z-score < -1. Obesity was defined using conventional BMI and %BF cutpoints and as sex-and race/ethnicity-specific FMI cutpoints. Glomerular filtration rate (GFR) was estimated using creatinine-(eGFR Cr ) and cystatin C-(eGFR Cys ). The prevalence of relative sarcopenia was higher than the prevalence of sarcopenia, especially in CKD stages 3b and 4 using eGFR Cr ; these CKD stages were associated with the highest FMI. CKD stage was independently associated with low ALMI FMI for age using eGFR Cys . BMI underestimated and %BF overestimated the prevalence of obesity compared with FMI. CKD was not independently associated with obesity by FMI. ConclusionsIn CKD, conventional definitions of sarcopenia underestimate muscle deficits and %BF overestimates the prevalence of obesity. CKD is independently associated with relative sarcopenia, but not excess adiposity.

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Section: Discussionmentioning

confidence: 99%

Sarcopenia, Relative Sarcopenia and Excess Adiposity in Chronic Kidney Disease

Ziolkowski

Long

Baker

et al. 2018

JCSM Clinical Reports

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“…1,2 In addition, black persons in the United States experience faster rates of kidney function decline at early stages of disease, compared with white persons. [3][4][5] The reasons for these observations remain unclear. Two variants in the gene encoding apolipoprotein L1 (APOL1) (termed G1 and G2), which are common among individuals with African ancestry, but very rare in Caucasian persons, are linked to ESRD and CKD.…”

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confidence: 99%

APOL1 Genotype and Race Differences in Incident Albuminuria and Renal Function Decline

Peralta

Bibbins‐Domingo

Vittinghoff

et al. 2016

Journal of the American Society of Nephrology

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Variants in the APOL1 gene are associated with kidney disease in blacks. We examined associations of APOL1 with incident albuminuria and kidney function decline among 3030 young adults with preserved GFR in the Coronary Artery Risk Development in Young Adults (CARDIA) study. eGFR by cystatin C (eGFRcys) and albumin-to-creatinine ratio were measured at scheduled examinations. Participants were white (n=1700), high-risk black (two APOL1 risk alleles, n=176), and low-risk black (zero/one risk allele, n=1154). Mean age was 35 years, mean eGFRcys was 107 ml/min per 1.73 m 2 , and 13.2% of blacks had two APOL1 alleles. The incidence rate per 1000 person-years (95% confidence interval) for albuminuria over 15 years was 15.6 (10.6-22.1) for high-risk blacks, 7.8 (6.4-9.4) for low-risk blacks, and 3.9 (3.1-4.8) for whites. Compared with whites, the odds ratio (95% confidence interval) for incident albuminuria was 5.71 (3.64-8.94) for high-risk blacks and 2.32 (1.73-3.13) for low-risk blacks. Adjustment for risk factors attenuated the difference between low-risk blacks and whites (odds ratio 1.21, 95% confidence interval 0.86-1.71). After adjustment, high-risk blacks had a 0.45% faster yearly eGFRcys decline over 9.3 years compared with whites. Low-risk blacks also had a faster yearly eGFRcys decline compared with whites, but this difference was attenuated after adjustment for risk factors and socioeconomic position. In conclusion, blacks with two APOL1 risk alleles had the highest risk for albuminuria and eGFRcys decline in young adulthood, whereas disparities between low-risk blacks and whites were related to differences in traditional risk factors.

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“…African Americans have higher risk for kidney failure. [4][5][6] The yearly incidence of ESRD in India is approximately 150-200pmp and DM is an important cause of CKD in approximately 30-40% of the patients. 7 CKD is defined as kidney damage or glomerular filtration rate (GFR) <60 mL/min/1.73 m 2 for 3 months or more, irrespective of cause.…”

Section: Introductionmentioning

confidence: 99%

Comparative study of serum urea, creatinine and C-reactive protein level in chronic kidney disease patients with healthy subjects

2017

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Background: Chronic diseases are a leading cause of morbidity and mortality in India. Globally, chronic kidney disease is the 12th cause of death and the 17th cause of disability, respectively. CKD is defined as kidney damage or glomerular filtration rate (GFR) <60 mL/min/1.73 m2 for 3 months or more, irrespective of cause. The present study aimed to find out correlation between serum urea, creatinine and C-reactive protein (CRP) level among patients suffering from chronic kidney disease in an urban based tertiary care hospital in Bikaner, western Rajasthan, India.Methods: This study was conducted at Sardar Patel Medical College and Associated Hospitals at Bikaner, Rajasthan from August 2015 to December 2016. There were 50 cases and 50 controls in the age groups from 10 to 60 yearrs. We took fresh samples and performed required tests following standard protocol. CRP has been done by Antigen Antibody reaction (latex method). RFT has been performed on semi-automatic analyzer.Results: Levels of serum urea and creatinine were significantly raised in CKD patients (p-value<0.005) and CRP level was raised in 52% cases. While 48% cases having normal level %), which requires further study. Renal function tests were significantly higher in cases than controls.Conclusions: Serum creatinine and urea level were significantly higher in cases as compared to control group.

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Racial and Ethnic Differences in Kidney Function Decline among Persons without Chronic Kidney Disease

Cited by 120 publications

References 31 publications

Sarcopenia, Relative Sarcopenia and Excess Adiposity in Chronic Kidney Disease

Sarcopenia, Relative Sarcopenia and Excess Adiposity in Chronic Kidney Disease

APOL1 Genotype and Race Differences in Incident Albuminuria and Renal Function Decline

Comparative study of serum urea, creatinine and C-reactive protein level in chronic kidney disease patients with healthy subjects

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