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Abstract: PO0432

Incidence and Racial Disparities in Cardiovascular Disease and CKD Progression in Young Adults with CKD

Session Information

Category: CKD (Non-Dialysis)

  • 2101 CKD (Non-Dialysis): Epidemiology, Risk Factors, and Prevention

Authors

  • Kula, Alexander J., Seattle Children's Hospital, Seattle, Washington, United States
  • Bansal, Nisha, University of Washington, Seattle, Washington, United States
  • Prince, David K., University of Washington, Seattle, Washington, United States
Background

Cardiovascular disease (CVD) is a major source of morbidity and mortality in adult CKD patients; yet is not well elucidated in young adults with CKD. Furthermore, racial and ethnic disparities in CVD and CKD progression has been found in research of pediatric and older-adult CKD populations, but has not been investigated specifically in young adults.

Methods

We studied 317 participants aged 21-40yrs of age with mild to moderate CKD enrolled in the Chronic Renal Insufficiency Cohort (CRIC) Study, of whom, 174 were black or Hispanic. We calculated incidence rates for CV events (heart failure [HF], MI, stroke, and death) and CKD progression (50% decline in eGFR or ESRD) for all young adult participants and as stratified by race and ethnicity. Cox proportional hazards regression models were constructed to test the association between race/ethnicity and CV events and CKD progression, adjusting for age, sex, eGFR, UACr, baseline SBP, and APOL1 status.

Results

HF, mortality and CKD progression had the highest incidence rates amongst young adults with CKD (Figure 1). Rates of these events were higher among Black and Hispanic participants: HF (17.5 vs. 5.1/1000 person-years), all-cause mortality (15.2 vs. 7.1/1000 person-years), and CKD progression (125 vs. 59/1000 person-years). Lastly, in adjusted models, black or Hispanic status was significantly associated with higher risk of CV events (HR: 1.25, 95%CI: 1.12-1.41) and CKD progression (HR: 1.38, 95%CI: 1.21-1.57).

Conclusion

Young adults with CKD in the CRIC study experience high incidence rates of cardiovascular disease. The burden of disease is even higher for black and Hispanic participants with CKD. Further research is required to better understand the factors underlying racial disparities in young adults with CKD.

Figure 1

Funding

  • NIDDK Support