Original InvestigationPathogenesis and Treatment of Kidney DiseaseRisk of Incident ESRD: A Comprehensive Look at Cardiovascular Risk Factors and 17 Years of Follow-up in the Atherosclerosis Risk in Communities (ARIC) Study
Section snippets
Study Population
The ARIC Study is a prospective observational cohort of 15,792 self-reported African American and white individuals between the ages of 45 and 64 years from 4 US communities (Forsyth County, NC; Jackson, MS; suburban Minneapolis, MN; and Washington County, MD). Participants took part in examinations starting with a baseline visit (visit 1) between 1987 and 1989. Individuals had 3 follow-up examinations at ∼3-year intervals at community clinics, as well as annual follow-up telephone interviews.
Results
Characteristics of the study population are listed in Table 1. In the 15,324 participants, subsequent ESRD was associated with older age, African American race, male sex, greater SCr level and lower baseline eGFR, diabetes, history of CHD, history of myocardial infarction, hypertension, current (and former) smoking, and greater BMI (Table 1).
During a median of 16 years, 241 cases of ESRD developed (incidence rate, 1.04 case/1,000 person-years; Table 2). Incidence rates were much higher in older
Discussion
This is one of few prospective studies of incident ESRD in a large population-based cohort with substantial follow-up and expands on current knowledge of several ESRD risk factors. We have confirmed known risk factors for ESRD, including African American race, diabetes, hypertension, and older age, but also show strong, independent, and graded relationships with ESRD for less well-studied cardiovascular risk factors, including smoking and serum triglyceride levels. These results also describe
Acknowledgements
The authors thank the staff and participants in the ARIC Study for their important contributions.
Support: ARIC is carried out as a collaborative study supported by National Heart, Lung, and Blood Institute contracts N01-HC-55015, N01-HC-55016, N01-HC-55018, N01-HC-55019, N01-HC-55020, N01-HC-55021, and N01-HC-55022. This study was supported in part by grants 5T32-HL-007024-33 (Dr Bash) and 5R01-DK-076770-02 (Dr Astor) from the National Institutes of Health.
Financial Disclosure: None.
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Originally published online as doi:10.1053/j.ajkd.2009.09.006 on November 23, 2009.
Because the Editor-in-Chief recused himself from consideration of this manuscript, the Deputy Editor (Daniel E. Weiner, MD, MS) served as Acting Editor-in-Chief. Details of the journal's procedures for potential editor conflicts are given in the Editorial Policies section of the AJKD website.