Kidney Week

Abstract: TH-PO1055

Risk Factors for CKD Progression in the Mexican Chronic Renal Insufficiency Cohort (MCRIC) Study

Session Information

• CKD: Epidemiology, Risk Factors, Prevention - I
  October 25, 2018 | Location: Exhibit Hall, San Diego Convention Center
  Abstract Time: 10:00 AM - 12:00 PM

Category: CKD (Non-Dialysis)

• 1901 CKD (Non-Dialysis): Epidemiology, Risk Factors, and Prevention

Authors

• Madero, Magdalena, Instituto Nacional de Cardiología, Ciudad de México, Mexico

Magdalena Madero,

• Chen, Jinsong, University of Illinois at Chicago, Chicago, Illinois, United States

Jinsong Chen,

• Ricardo, Ana C., University of Illinois at Chicago, Chicago, Illinois, United States

Ana C. Ricardo,

• Carmona, Eunice, University of Illinois at Chicago, Chicago, Illinois, United States

Eunice Carmona,

• Hernández martínez, Ana Paulina, Instituto Nacional de Cardiología, Ciudad de México, Mexico

Ana Paulina Hernández martínez,

• Fernández yepez, Ana K., Instituto Nacional de Cardiología, Ciudad de México, Mexico

Ana K. Fernández yepez,

• Cedillo-Couvert, Esteban A., University of Illinois at Chicago, Chicago, Illinois, United States

Esteban A. Cedillo-Couvert,

• Kansal, Mayank, University of Illinois at Chicago, Chicago, Illinois, United States

Mayank Kansal,

• Moguel, Bernardo, Instituto Nacional de Cardiología, Ciudad de México, Mexico

Bernardo Moguel,

• Linares-Koloffon, Carlos A., University of Illinois at Chicago, Chicago, Illinois, United States

Carlos A. Linares-Koloffon,

• Lash, James P., University of Illinois at Chicago, Chicago, Illinois, United States

James P. Lash,

Background

Chronic kidney disease (CKD) is a major public health problem in Mexico. However, little is known about the risk factors for progression of kidney disease among individuals with CKD living in Mexico.

Methods

MCRIC is an ongoing, prospective observational cohort study of adults with CKD recruited from a referral center in Mexico City, with entry estimated glomerular filtration rate (eGFR) 20-60 ml/min/1.73 m². Using data from 257 participants who completed at least two study visits, we conducted Cox proportional hazards regression analysis to evaluate risk factors for CKD progression defined as 30% decline in eGFR from baseline.

Results

At study entry, mean age was 56.6 ± 0.8 years, 72.2% were male, 23% reported current cigarette smoking, and 53% had a diagnosis of diabetes. Mean body mass index (BMI) and systolic blood pressure (SBP) were 28.2 ± 4.5 Kg/m² and 123.4 ± 19.6 mmHg, respectively. The mean baseline eGFR was 41.1 ± 15.4 ml/min/1.73m², and the median (IQR) urine protein excretion 633 (124-2460) mg/24 hours. During a median follow-up of 1.9 years, there were 57 CKD progression events (event rate 11.3 per 100 person-years). In unadjusted analysis, significant predictors of CKD progression included diabetes (HR, 95% CI, 2.00, 1.15-3.50) and higher log-transformed urine protein (1.62, 1.34-1.95). After adjusting for age, sex, SBP, baseline eGFR and diabetes, only proteinuria remained a significant predictor (1.64, 1.33-2.04).

Conclusion

This cohort of adults with CKD in Mexico experienced a high rate of CKD progression which was significantly associated with baseline proteinuria. Long-term follow-up is needed to better understand risk factors for CKD progression in this population.

Funding

• NIDDK Support