Risk Factors for CKD Progression

Hannan, Mary; Ansari, Sajid; Meza, Natalie; Anderson, Amanda H.; Srivastava, Anand; Waikar, Sushrut S.; Charleston, Jeanne; Weir, Matthew R.; Taliercio, Jonathan J.; Horwitz, Edward; Saunders, Milda R.; Wolfrum, Katherine M.; Feldman, Harold I.; Lash, James P.; Ricardo, Ana C.

doi:10.2215/cjn.07830520

Cited by 87 publications

(59 citation statements)

References 84 publications

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“…All baseline (indexed at the individual's first eGFR observation) covariates known to be associated with CKD 2 were included in models: demographic factors (age, race and gender) and co‐morbidities (DM, HTN, body mass index [BMI] and CVD [left ventricular hypertrophy [LVH], angina and stroke]). Psychiatric diseases associated with PTSD 10 (major depressive disorder [MDD] and generalized anxiety disorder [GAD]); psychiatric medications (selective serotonin reuptake inhibitors [SSRIs], tricyclic antidepressants [TCAs] and ‘others’ [not classified]), substance abuse (smoking [pack years] and alcohol intake [alcohol score]) were also included.…”

Section: Methodsmentioning

confidence: 99%

“…Chronic kidney disease (CKD) is a common condition associated with high morbidity, mortality and health‐care costs 1 . While numerous risk factors for CKD progression are known, 2 emerging evidence indicates that mental health disorders are highly comorbid with CKD 3 . Major depression is known to be associated with CKD progression 4 and with estimated glomerular filtration rate (eGFR) decline in the general population 5 .…”

Section: Introductionmentioning

confidence: 99%

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The association of post‐traumatic stress disorder with glomerular filtration rate decline

et al. 2023

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While major depression is known to be associated with glomerular filtration rate (GFR) decline, there is a lack of data on the association of other mental illnesses like posttraumatic stress disorder (PTSD) with kidney disease. In 640 adult participants of the Heart and Soul Study (mean baseline age of 66.2 years) with a high prevalence cardiovascular disease, hypertension and diabetes, we examined the association of PTSD with GFR decline over a 5-year follow-up. We observed a significantly greater estimated (e) GFR decline over time in those with PTSD compared to those without (2.97 vs. 2.11 ml/min/1.73 m 2 /year; p = .022). PTSD was associated with 91% (95% CI 12%-225%) higher odds of 'rapid' versus 'mild' (>3.0 vs. <3.0 ml/min/1.73 m 2 / per year) eGFR decline. These associations remained consistent despite controlling for demographics, medical comorbidities, other mental disorders and psychiatric medications. In conclusion, our study provides evidence that PTSD is independently associated with GFR decline in middle-aged adults with a high comorbidity burden. This association needs to be examined in larger cohorts with longer follow-ups.

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Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

The association of post‐traumatic stress disorder with glomerular filtration rate decline

et al. 2023

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“…Prior publications have described the design of the CRIC Study. [11][12][13] This study recruited 5,625…”

Section: Study Design and Populationmentioning

confidence: 99%

Associations of Anxiety during the COVID-19 Pandemic with Patient Characteristics and Behaviors in CKD Patients: Findings from the Chronic Renal Insufficiency Cohort (CRIC) Study

et al. 2022

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Background. Chronic kidney disease (CKD) is associated with anxiety and depression. Although the Coronavirus 2019 (COVID-19) pandemic has increased stressors on patients with CKD, assessments of anxiety, its predictors and consequences on behaviors, specifically virus mitigation behaviors, are lacking. Methods. From June to October 2020, we administered a survey to 1,873 patients in the Chronic Renal Insufficiency Cohort (CRIC) study, asking participants about anxiety related to the COVID-19 pandemic. We examined associations between anxiety and participant demographics, clinical indices, and health literacy and whether anxiety was associated with health-related behaviors and COVID-19 mitigation behaviors. Results. Mean age of the study population was 70 (SD 9.6) years, 47% were women, 39% were Black Non-Hispanic, 14% were Hispanic, and 38% had a history of cardiovascular disease. In adjusted analyses, younger age, female gender, Hispanic ethnicity, cardiovascular disease, household income <$20,000, and marginal or inadequate health literacy predicted higher anxiety. Higher global COVID-19-related anxiety scores were associated with higher odds of reporting always wearing a mask in public (OR 1.30 (1.14, 1.48), p<0.001) and of eating less healthy foods (OR (95%CI) 1.29 (1.13, 1.46), p<0.001), reduced physical activity (OR 1.32 (1.20, 1.45), p<0.001), and weight gain (OR (1.23 (1.11, 1.38), p=0.001). Conclusion. Higher anxiety levels related to the COVID-19 pandemic were associated with higher self-reported adherence to mask wearing but also with higher weight gain and less adherence to healthy lifestyle behaviors. Interventions are needed to support continuation of healthy lifestyle behaviors in patients with CKD experiencing increased anxiety related to the pandemic.

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“…Over the past decade, the CRIC study has contributed substantially to our understanding of factors associated with CKD progression. Hannan [15]. The current fourth phase, which began in 2018, is increasing the ethnic diversity of the cohort by recruiting 500 Native American and 126 Hispanic adults.…”

Section: Chronic Renal Insufficiency Cohort (Cric)mentioning

confidence: 99%

Clinical epidemiological analysis of cohort studies investigating the pathogenesis of kidney disease

et al. 2021

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In recent years, large cohort studies of patients with chronic kidney disease (CKD) have been established all over the world. These studies have attempted to analyze the pathogenesis of CKD using a large body of published evidence. The design of cohort studies is characterized by the measurement of the exposure prior to the occurrence of the outcome, which has the advantage of clarifying the temporal relationship between predictors and outcomes and estimating the strength of the causal relationship between predictors and multiple outcomes. Recent advances in biostatistical analysis methods, such as propensity scores and risk prediction models, are facilitating causal inference using higher quality evidence with greater precision in observational studies. In this review, we will discuss clinical epidemiological research of kidney disease based on the analysis of observational cohort data sets, with a focus on our previous studies.

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Risk Factors for CKD Progression

Cited by 87 publications

References 84 publications

The association of post‐traumatic stress disorder with glomerular filtration rate decline

The association of post‐traumatic stress disorder with glomerular filtration rate decline

Associations of Anxiety during the COVID-19 Pandemic with Patient Characteristics and Behaviors in CKD Patients: Findings from the Chronic Renal Insufficiency Cohort (CRIC) Study

Clinical epidemiological analysis of cohort studies investigating the pathogenesis of kidney disease

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