Dataset Information

Geographic variation in CKD prevalence and ESRD incidence in the United States: results from the reasons for geographic and racial differences in stroke (REGARDS) study.

ABSTRACT: It is not known whether geographic differences in the prevalence of chronic kidney disease exist and are associated with end-stage renal disease (ESRD) incidence rates across the United States.Cross-sectional and ecologic.White (n = 16,410) and black (n = 11,109) participants from across the continental United States in the population-based Reasons for Geographic and Racial Differences in Stroke (REGARDS) Study.Geographic region, defined by the 18 networks of the US ESRD Network Program.Albuminuria, defined as albumin-creatinine ratio ?30 mg/g, and decreased estimated glomerular filtration rate (eGFR), defined as <60 mL/min/1.73 m(2), were measured in the REGARDS Study. ESRD incidence rates were obtained from the US Renal Data System.For whites, the network-specific prevalence of albuminuria ranged from 8.4% (95% CI, 3.3%-13.5%) in Network 15 to 14.8% (95% CI, 8.0%-21.6%) in Network 3, and decreased eGFR ranged from 4.3% (95% CI, 2.0%-6.6%) in Network 4 to 16.7% (95% CI, 12.7%-20.7%) in Network 7. For blacks, the prevalence of albuminuria ranged from 12.1% (95% CI, 8.7%-15.5%) in Network 5 to 26.5% (95% CI, 16.7%-36.3%) in Network 4, and decreased eGFR ranged from 6.7% (95% CI, 5.0%-8.4%) in Network 17/18 to 13.4% (95% CI, 7.8%-19.1%) in Network 12. Spearman correlation coefficients for the prevalence of albuminuria and decreased eGFR with network-specific ESRD incidence rates were 0.49 and 0.24, respectively, for whites and 0.29 and 0.25, respectively, for blacks.There were few cases of albuminuria and decreased eGFR in some geographic regions.In the United States, substantial geographic variations in the prevalence of albuminuria and decreased eGFR exist, but were correlated only modestly with ESRD incidence, suggesting the chronic kidney disease burden may not explain the geographic variation in ESRD incidence.

SUBMITTER: Tanner RM

PROVIDER: S-EPMC3659181 | biostudies-other | 2013 Mar

REPOSITORIES: biostudies-other

ACCESS DATA

Publications

Geographic variation in CKD prevalence and ESRD incidence in the United States: results from the reasons for geographic and racial differences in stroke (REGARDS) study.

Tanner Rikki M RM Gutiérrez Orlando M OM Judd Suzanne S McClellan William W Bowling C Barrett CB Bradbury Brian D BD Safford Monika M MM Cushman Mary M Warnock David D Muntner Paul P

American journal of kidney diseases : the official journal of the National Kidney Foundation 20121208 3

<h4>Background</h4>It is not known whether geographic differences in the prevalence of chronic kidney disease exist and are associated with end-stage renal disease (ESRD) incidence rates across the United States.<h4>Study design</h4>Cross-sectional and ecologic.<h4>Setting & participants</h4>White (n = 16,410) and black (n = 11,109) participants from across the continental United States in the population-based Reasons for Geographic and Racial Differences in Stroke (REGARDS) Study.<h4>Predictor< ...[more]

PMID: 23228944

Similar Datasets

Project description:Studies suggest that treatment-resistant hypertension is common and increasing in prevalence among US adults. Although hypertension is a risk factor for end-stage renal disease (ESRD), few data are available for the association between treatment-resistant hypertension and ESRD risk.Prospective cohort study.We analyzed data from 9,974 REGARDS (Reasons for Geographic and Racial Differences in Stroke) Study participants treated for hypertension without ESRD at baseline.Treatment-resistant hypertension was defined as uncontrolled blood pressure (BP) with concurrent use of 3 antihypertensive medication classes including a diuretic or use of 4 or more antihypertensive medication classes including a diuretic regardless of BP.Incident ESRD was identified by linkage of REGARDS Study participants with the US Renal Data System.During a baseline in-home study visit, BP was measured twice and classes of antihypertensive medication being taken were determined by pill bottle inspection.During a median follow-up of 6.4 years, there were 152 incident cases of ESRD (110 ESRD cases among 2,147 with treatment-resistant hypertension and 42 ESRD cases among 7,827 without treatment-resistant hypertension). The incidence of ESRD per 1,000 person-years for hypertensive participants with and without treatment-resistant hypertension was 8.86 (95% CI, 7.35-10.68) and 0.88 (95% CI, 0.65-1.19), respectively. After multivariable adjustment, the HR for ESRD comparing hypertensive participants with versus without treatment-resistant hypertension was 6.32 (95% CI, 4.30-9.30). Of participants who developed incident ESRD during follow-up, 72% had treatment-resistant hypertension at baseline.BP, estimated glomerular filtration rate, and albuminuria assessed at a single time.Individuals with treatment-resistant hypertension are at increased risk for ESRD. Appropriate clinical management strategies are needed to treat treatment-resistant hypertension in order to preserve kidney function in this high-risk group.

Project description:BackgroundLow adherence to antihypertensive medication is an important barrier to achieving blood pressure control. Few data are available for medication adherence in adults with chronic kidney disease (CKD).Study designCross-sectional.Setting & participants3,936 and 9,129 participants with and without CKD using antihypertensive medication in the REGARDS (Reasons for Geographic and Racial Differences in Stroke) Study, respectively. CKD was defined as albuminuria with albumin excretion>or=30 mg/g or estimated glomerular filtration rate<60 mL/min/1.73 m2.OutcomesMedication adherence and uncontrolled hypertension.MeasurementsMedication adherence was assessed using a validated 4-item scale. Blood pressure was measured 2 times by trained staff.ResultsIn REGARDS participants with and without CKD, 1,426 (36.2%) and 2,421 (26.5%) had uncontrolled hypertension with blood pressure>or=140/90 mm Hg, and 2,656 (67.5%) and 5,627 (61.6%), >or=130/80 mm Hg. Also, 27.7% of those with CKD and 27.9% of those without CKD responded "yes" to ever forgetting to take their medication and 4.4% and 4.2%, respectively, responded yes to being careless about taking their medication. Also, 5.7% and 5.3% responded yes to missing taking medication when they felt better, and 4.2% and 3.6%, to missing it when they felt sick. Overall, 23.3% and 23.7% of participants with and without CKD responded yes to 1 adherence question, whereas 7.7% and 7.2%, respectively, responded yes to 2 or more adherence questions. In those with CKD, the multivariable adjusted ORs for uncontrolled hypertension (blood pressure>or=140/90 mm Hg) for individuals answering yes to 1 and 2 or more versus 0 adherence questions were 1.26 (95% CI, 1.05-1.51) and 1.49 (95% CI, 1.12-1.98), respectively. Analogous ORs for systolic/diastolic blood pressure>or=130/80 mm Hg were 1.06 (95% CI, 0.78-1.45) and 1.20 (95% CI, 0.88-1.64).LimitationsPharmacy fill data were not available.ConclusionsIndividuals with CKD had similarly poor medication-taking behaviors as those without CKD.

Dataset Information

Geographic variation in CKD prevalence and ESRD incidence in the United States: results from the reasons for geographic and racial differences in stroke (REGARDS) study.

Publications

Geographic variation in CKD prevalence and ESRD incidence in the United States: results from the reasons for geographic and racial differences in stroke (REGARDS) study.

Similar Datasets

OmicsDI is part of the ELIXIR infrastructure

Tweets