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Kidney Week

Abstract: SA-PO441

Global Variation in Rates of ESRD and Death among the ISN’s International Network of CKD Cohort Studies (iNET-CKD)

Session Information

Category: Chronic Kidney Disease (Non-Dialysis)

  • 304 CKD: Epidemiology, Outcomes - Non-Cardiovascular

Authors

  • Orlandi, Paula Ferreira, University of Pennsylvania, Philadelphia, Pennsylvania, United States
  • Shardlow, Adam, Royal Derby Hospital, Derby, United Kingdom
  • Levin, Adeera, St. Paul's Hospital and University of British Columbia, Vancouver, British Columbia, Canada
  • Ahn, Curie, Seoul National University Hospital, Seoul, Korea (the Republic of)
  • Healy, Helen G., None, Philadelphia, Pennsylvania, United States
  • Oh, Kook-Hwan, Seoul National University Hospital, Seoul, Korea (the Republic of)
  • Sola, Laura, CASMU-IAMPP, Montevideo, Uruguay
  • Nessel, Lisa C., University of Pennsylvania, Philadelphia, Pennsylvania, United States
  • Taal, Maarten W., None, Philadelphia, Pennsylvania, United States
  • Fukagawa, Masafumi, Tokai University School of Medicine, Isehara, Kanagawa, Japan
  • Fujii, Naohiko, Hyogo Prefectural Nishinomiya Hospital , Nishinomiya, Japan
  • Djurdjev, Ognjenka, BC Renal Agency, Vancouver, Alberta, Canada
  • Rios, Pablo, National Fund of Resources, Montevideo, Uruguay
  • Yang, Wei, University of Pennsylvania, Philadelphia, Pennsylvania, United States
  • Hoy, Wendy E., The University of Queensland, Brisbane, Queensland, Australia
  • Feldman, Harold I., University of Pennsylvania, Philadelphia, Pennsylvania, United States
Background

Little is known about the variability in rates of CKD progression and death among CKD populations across the globe. The aim of this study was to assess this variability among cohorts that are members of iNET-CKD.

Methods

Group-level analysis comparing rates of CKD progression and death among 7 iNET-CKD cohorts. A total of 34,466 participants with eGFR < 90 ml/min/1.73m2 were included. Crude incidence rates were calculated overall and stratified by CKD stage. Cox regression models were performed to compare relative rates of CKD progression and death adjusted for age, sex, education, history of diabetes, cardiovascular disease, systolic blood pressure, BMI, smoking status, and proteinuria.

Results

Overall, crude rates (100 p-y) varied from 3.1 (95%CI: 3.0-3.3) to 9.2 (95%CI: 8.6-10.0) (100 p-y) for CKD progression and from 0.8 (95%CI: 0.6-1.1) to 6.0 (95%CI: 5.6-6.6) for death. Rates of CKD progression among participants with CKD stage 4 varied from 0 to 19.2 (95%CI: 17.7-20.8) and for death varied from 1.0 (95%CI:0.7-1.4) to 11.2 (95%CI: 9.9-12.7). The contrast among study rates remained significant after adjustment for baseline characteristics (figure).

Conclusion

Crude rates and adjusted relative rates of CKD progression and death vary extensively among iNET-CKD cohorts. Both findings suggest that factors that mediate CKD progression and death vary across countries and represent opportunities for future research.

Adjusted hazard ratios for CKD progression and death across CKD stages for each cohort study (reference group: CKD stage 2)