Lesley A Inker1, Hocine Tighiouart2, Thor Aspelund3, Vilmundur Gudnason3, Tamara Harris4, Olafur S Indridason5, Runolfur Palsson6, Shani Shastri7, Andrew S Levey8, Mark J Sarnak8. 1. Division of Nephrology and linker@tuftsmedicalcenter.org. 2. Institute for Clinical Research and Health Policy Studies, Tufts Medical Center, Boston, Massachusetts; Tufts Clinical and Translational Science Institute, Tufts University, Boston, Massachusetts; 3. Icelandic Heart Association, Kopavogur, Iceland; Centre for Public Health Sciences, University of Iceland, Reykjavik, Iceland; 4. National Institute on Aging, Bethesda, Maryland; 5. Division of Nephrology, Landspitali - National University Hospital of Iceland, Reykjavik, Iceland; and. 6. Centre for Public Health Sciences, University of Iceland, Reykjavik, Iceland; Division of Nephrology, Landspitali - National University Hospital of Iceland, Reykjavik, Iceland; and. 7. Division of Nephrology, University of Texas Southwestern, Dallas, Texas. 8. Division of Nephrology and.
Abstract
BACKGROUND AND OBJECTIVES: Lifetime risk estimates of CKD can be used effectively in public education campaigns. This study sought to estimate lifetime risk of incident CKD stage 3 and higher in Iceland for people without CKD by the age of 45 years. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: This was a prospective cohort study with longitudinal creatinine measurements of residents in Reykjavik, Iceland, from 1967 to 2005. CKD was ascertained by two consecutive eGFR measurements <60 ml/min per 1.73 m(2), development of treated kidney failure, one eGFR<60 ml/min per 1.73 m(2) if the participant died before the next evaluation, or one eGFR<45 ml/min per 1.73 m(2) if it was the last eGFR. RESULTS: Mean follow-up was 25 (SD 10) years. Of the study participants, 727 (19%) developed the outcome and 942 (24%) died first. By age 85 years, the lifetime risks for 45-year-old women and men without prevalent CKD were 35.8% (95% confidence interval [95% CI], 32.7 to 38.9) and 21.3% (95% CI, 18.7 to 23.8), respectively. Risk was higher in individuals with a lower eGFR, hypertension, and a higher body mass index. Lifetime risk for higher stages of CKD 3b and 4 were less common than stage 3a; by age 85 years, the lifetime risks for CKD stages 3a, 3b, and 4 in women were 38.5% (95% CI, 25.8 to 51.1), 19.4% (95% CI, 8.9 to 29.9), and 3.6% (95% CI, 2.2 to 5.0), respectively. CONCLUSIONS: The lifetime risk of developing CKD stage 3 or higher is substantial, emphasizing the importance of strategies to prevent development of CKD throughout the course of life. Estimates are lower than reported using single estimates of GFR, emphasizing the importance of confirming estimates of reduced GFR in studies of CKD.
BACKGROUND AND OBJECTIVES: Lifetime risk estimates of CKD can be used effectively in public education campaigns. This study sought to estimate lifetime risk of incident CKD stage 3 and higher in Iceland for people without CKD by the age of 45 years. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: This was a prospective cohort study with longitudinal creatinine measurements of residents in Reykjavik, Iceland, from 1967 to 2005. CKD was ascertained by two consecutive eGFR measurements <60 ml/min per 1.73 m(2), development of treated kidney failure, one eGFR<60 ml/min per 1.73 m(2) if the participant died before the next evaluation, or one eGFR<45 ml/min per 1.73 m(2) if it was the last eGFR. RESULTS: Mean follow-up was 25 (SD 10) years. Of the study participants, 727 (19%) developed the outcome and 942 (24%) died first. By age 85 years, the lifetime risks for 45-year-old women and men without prevalent CKD were 35.8% (95% confidence interval [95% CI], 32.7 to 38.9) and 21.3% (95% CI, 18.7 to 23.8), respectively. Risk was higher in individuals with a lower eGFR, hypertension, and a higher body mass index. Lifetime risk for higher stages of CKD 3b and 4 were less common than stage 3a; by age 85 years, the lifetime risks for CKD stages 3a, 3b, and 4 in women were 38.5% (95% CI, 25.8 to 51.1), 19.4% (95% CI, 8.9 to 29.9), and 3.6% (95% CI, 2.2 to 5.0), respectively. CONCLUSIONS: The lifetime risk of developing CKD stage 3 or higher is substantial, emphasizing the importance of strategies to prevent development of CKD throughout the course of life. Estimates are lower than reported using single estimates of GFR, emphasizing the importance of confirming estimates of reduced GFR in studies of CKD.
Authors: Richard D Semba; Jeffrey C Fink; Kai Sun; Anne R Cappola; Mansi Dalal; Candace Crasto; Luigi Ferrucci; Linda P Fried Journal: Clin J Am Soc Nephrol Date: 2011-11-10 Impact factor: 8.237
Authors: Jan A J G van den Brand; Gerben A J van Boekel; Hans L Willems; Lambertus A L M Kiemeney; Martin den Heijer; Jack F M Wetzels Journal: Nephrol Dial Transplant Date: 2011-02-16 Impact factor: 5.992
Authors: Marije van der Velde; Kunihiro Matsushita; Josef Coresh; Brad C Astor; Mark Woodward; Andrew Levey; Paul de Jong; Ron T Gansevoort; Marije van der Velde; Kunihiro Matsushita; Josef Coresh; Brad C Astor; Mark Woodward; Andrew S Levey; Paul E de Jong; Ron T Gansevoort; Andrew Levey; Meguid El-Nahas; Kai-Uwe Eckardt; Bertram L Kasiske; Toshiharu Ninomiya; John Chalmers; Stephen Macmahon; Marcello Tonelli; Brenda Hemmelgarn; Frank Sacks; Gary Curhan; Allan J Collins; Suying Li; Shu-Cheng Chen; K P Hawaii Cohort; Brian J Lee; Areef Ishani; James Neaton; Ken Svendsen; Johannes F E Mann; Salim Yusuf; Koon K Teo; Peggy Gao; Robert G Nelson; William C Knowler; Henk J Bilo; Hanneke Joosten; Nanno Kleefstra; K H Groenier; Priscilla Auguste; Kasper Veldhuis; Yaping Wang; Laura Camarata; Beverly Thomas; Tom Manley Journal: Kidney Int Date: 2011-02-09 Impact factor: 10.612
Authors: Meredith C Foster; Andreea M Rawlings; Elizabeth Marrett; David Neff; Kerry Willis; Lesley A Inker; Josef Coresh; Elizabeth Selvin Journal: Am Heart J Date: 2013-05-01 Impact factor: 4.749
Authors: Brad C Astor; Kunihiro Matsushita; Ron T Gansevoort; Marije van der Velde; Mark Woodward; Andrew S Levey; Paul E de Jong; Josef Coresh; Brad C Astor; Kunihiro Matsushita; Ron T Gansevoort; Marije van der Velde; Mark Woodward; Andrew S Levey; Paul E de Jong; Josef Coresh; Meguid El-Nahas; Kai-Uwe Eckardt; Bertram L Kasiske; Jackson Wright; Larry Appel; Tom Greene; Adeera Levin; Ognjenka Djurdjev; David C Wheeler; Martin J Landray; John N Townend; Jonathan Emberson; Laura E Clark; Alison Macleod; Angharad Marks; Tariq Ali; Nicholas Fluck; Gordon Prescott; David H Smith; Jessica R Weinstein; Eric S Johnson; Micah L Thorp; Jack F Wetzels; P J Blankestijn; A D van Zuilen; Vandana Menon; Mark Sarnak; Gerald Beck; Florian Kronenberg; Barbara Kollerits; Marc Froissart; Benedicte Stengel; Marie Metzger; Giuseppe Remuzzi; Piero Ruggenenti; Annalisa Perna; H J Lambers Heerspink; Barry Brenner; Dick de Zeeuw; Peter Rossing; Hans-Henrik Parving; Priscilla Auguste; Kasper Veldhuis; Yaping Wang; Laura Camarata; Beverly Thomas; Tom Manley Journal: Kidney Int Date: 2011-02-02 Impact factor: 10.612
Authors: Bakhtawar K Mahmoodi; Kunihiro Matsushita; Mark Woodward; Peter J Blankestijn; Massimo Cirillo; Takayoshi Ohkubo; Peter Rossing; Mark J Sarnak; Bénédicte Stengel; Kazumasa Yamagishi; Kentaro Yamashita; Luxia Zhang; Josef Coresh; Paul E de Jong; Brad C Astor Journal: Lancet Date: 2012-09-24 Impact factor: 79.321
Authors: Stein I Hallan; Kunihiro Matsushita; Yingying Sang; Bakhtawar K Mahmoodi; Corri Black; Areef Ishani; Nanne Kleefstra; David Naimark; Paul Roderick; Marcello Tonelli; Jack F M Wetzels; Brad C Astor; Ron T Gansevoort; Adeera Levin; Chi-Pang Wen; Josef Coresh Journal: JAMA Date: 2012-12-12 Impact factor: 56.272
Authors: Dorothea Nitsch; Morgan Grams; Yingying Sang; Corri Black; Massimo Cirillo; Ognjenka Djurdjev; Kunitoshi Iseki; Simerjot K Jassal; Heejin Kimm; Florian Kronenberg; Cecilia M Oien; Andrew S Levey; Adeera Levin; Mark Woodward; Brenda R Hemmelgarn Journal: BMJ Date: 2013-01-29
Authors: Pankti A Gheewala; Syed Tabish R Zaidi; Matthew D Jose; Luke Bereznicki; Gregory M Peterson; Ronald L Castelino Journal: J Nephrol Date: 2017-02-08 Impact factor: 3.902