Nontraditional Risk Factors for Progression Through Chronic Kidney Disease Risk Categories: The Coronary Artery Risk Development in Young Adults Study |
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| Affiliation: | 1. Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis;2. Departments of Public Health Sciences and Medicine, Loyola University Chicago, Maywood, Ill;3. Division of Cardiology and Department of Medicine, Hennepin Healthcare, University of Minnesota Medical School, Minneapolis;4. Department of Population of Health Sciences, Kidney Health Research Institute, Department of Nephrology, Geisinger Medical Center, Danville, Penn;5. Cardiovascular Division, Department of Medicine, University of Minnesota, Minneapolis;1. Department of Internal Medicine, University of Michigan, Ann Arbor;2. Institute for Healthcare Policy and Innovation, University of Michigan, Ann Arbor;3. VA Ann Arbor Center for Clinical Management Research, Ann Arbor, Mich;4. Yale School of Medicine, New Haven, Conn;5. VA Connecticut Healthcare System, West Haven;1. Department of Medicine, University of Florida, Gainesville;2. Division of Cardiovascular Medicine, University of Florida, Gainesville;1. Department of Hematology, Alexandra General Hospital, Athens, Greece;2. Department of Internal Medicine, Tenon Hospital, Paris, France;3. Department of Gynecology, Alexandra General Hospital, Athens, Greece;4. Department of Radiology, Second Department of Radiology, National and Kapodistrian University of Athens, Athens, Greece;5. Department of Neurology, Aiginiteio Hospital, Athens, Greece;1. Department of Medicine, Laniado Hospital, Sanz Medical Centre , Netanya, Israel;2. Faculty of Medicine, Hebrew University and Hadassah Medical School, Jerusalem, Israel;3. Faculty of Medicine, Ariel University, Ariel, Israel;4. Imaging, Laniado Hospital, Sanz Medical Centre, Netanya, Israel;1. Division of Infectious Diseases, Department of Medicine, University of California Los Angeles;2. Provincial Laboratory for Public Health, Alberta Precision Laboratories, Alberta, Canada;3. Department of Pathology and Laboratory Medicine, University of Alberta, Edmonton, Alberta, Canada;4. Division of Infectious Diseases, Department of Medicine, University of Alberta, Edmonton, Alberta, Canada |
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| Abstract: | BackgroundThere may be nontraditional pathways of chronic kidney disease (CKD) progression that are complementary to classical pathways. Therefore, we aimed to examine nontraditional risk factors for incident CKD and its progression.MethodsWe used the generally healthy population (n = 4382) starting at age 27-41 years in the Coronary Artery Risk Development in Young Adults (CARDIA) cohort, which is an observational longitudinal study. Nontraditional risk factors included forced vital capacity, inflammation, serum urate, and serum carotenoids. CKD risk category was classified using the estimated glomerular filtration rate (eGFR) and urinary albumin-to-creatinine ratio (UACR) measured in 1995-1996 and repeated every 5 years for 20 years: No CKD, low risk, moderate risk, high risk, and very high risk.ResultsAt baseline, 84.8% had no CKD (eGFR ≥60 mL/min/1.73 m2 and UACR <10 mg/g), 10.3% were in the low risk (eGFR ≥60 and UACR 10-29), and 4.9% had CKD (eGFR <60 and/or UACR ≥ 30). Nontraditional risk factors were significantly associated with the progression of CKD to higher categories. Hazard ratios per standard deviation of the predictor for incident CKD and its progression from the No CKD and low and moderate risk into CKD were inverse for forced vital capacity and serum carotenoids and positive for serum urate, GlycA, and C-reactive protein, the first 3 even after adjustment for conventional risk factors.ConclusionSeveral nontraditional markers were significantly associated with an increased risk of progression to higher CKD categories in generally healthy young to middle-aged adults. |
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