期刊
JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION
卷 312, 期 20, 页码 2115-2125出版社
AMER MEDICAL ASSOC
DOI: 10.1001/jama.2014.15063
关键词
-
资金
- National Heart, Lung, and Blood Institute (NHLBI) [HHSN268201100005C, HHSN268201100006C, HHSN268201100007C, HHSN268201100008C, HHSN268201100009C, HHSN268201100010C, HHSN268201100011C, HHSN268201100012C, R01HL087641, R01HL59367]
- National Human Genome Research Institute (NHGRI) [U01HG004402]
- National Institutes of Health (NIH) [HHSN268200625226C]
- NIH through the American Recovery and Reinvestment Act (ARRA) [5RC2HL102419]
- Baylor Genome Center [U54 HG003273]
- Duke University Medical Center [5K12 HL087097-0]
- University of North Carolina Clinical Hematology Research Career Development Program
- NHLBI [AG0005, N01-HC-95159, 01-HC-95160, N01-HC-95161, N01-HC-95162, N01-HC-95163, N01-HC-95164, N01-HC-95165, N01-HC-95166, N01-HC-95167]
- National Institute on Minority Health and Health Disparities [HHSN268201300046C, HHSN268201300047C, HHSN268201300048C, HHSN268201300049C, HHSN268201300050C, RC4MD005964]
- University of Alabama at Birmingham [HHSN268201300025C, HSN268201300026C]
- Northwestern University [HHSN268201300027C]
- University of Minnesota [HHSN268201300028C]
- Kaiser Foundation Research Institute [HHSN268201300029C]
- Johns Hopkins University School of Medicine [HHSN268200900041C]
- Intramural Research Program of the National Institute on Aging (NIA)
- NIA [AG0005]
- National Center for Research Resources [UL1-TR-000040, UL1-RR-025005]
- NIH [R01 DK089174, R01 DK076770-01, 1R01DK102134-01]
- US Department of Health and Human Services [HHSN268201100046C, HHSN268201100001C, HHSN268201100002C, HHSN268201100003C, HHSN268201100004C, HHSN271201100004C]
- National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) [DK085501, DK085524, DK085526, DK085545, DK085584]
- NHGRI [5u54HG003067, U54 HG003067]
- NIDDK [R01 DK089174, R01 DK076770-01]
- NHLBI. [R01HL086694, N01-HC-95168, N01-HC-95169, RC2 HL-103010, RC2 HL-102923, RC2 HL-102924, RC2 HL-102925, RC2 HL-102926, R01HL107816, HL080494-05, 2K12HL087169-06, T32HL007208, 1UO1HL117659, R01HL071862]
IMPORTANCE The association between sickle cell trait (SCT) and chronic kidney disease (CKD) is uncertain. OBJECTIVE To describe the relationship between SCT and CKD and albuminuria in self-identified African Americans. DESIGN, SETTING, AND PARTICIPANTS Using 5 large, prospective, US population-based studies (the Atherosclerosis Risk in Communities Study [ARIC, 1987-2013; n = 3402], Jackson Heart Study [JHS, 2000-2012; n = 2105], Coronary Artery Risk Development in Young Adults [CARDIA, 1985-2006; n = 848], Multi-Ethnic Study of Atherosclerosis [MESA, 2000-2012; n = 1620], and Women's Health Initiative [WHI, 1993-2012; n = 8000]), we evaluated 15 975 self-identified African Americans (1248 participants with SCT [SCT carriers] and 14 727 participants without SCT [noncarriers]). MAIN OUTCOMES AND MEASURES Primary outcomes were CKD (defined as an estimated glomerular filtration rate [eGFR] of <60 mL/min/1.73m(2) at baseline or follow-up), incident CKD, albuminuria (defined as a spot urine albumin: creatinine ratio of >30mg/g or albumin excretion rate >30mg/24 hours), and decline in eGFR (defined as a decrease of >3 mL/min/1.73m2 per year). Effect sizes were calculated separately for each cohort and were subsequently meta-analyzed using a random-effects model. RESULTS A total of 2233 individuals (239 of 1247 SCT carriers [19.2%] vs 1994 of 14 722 noncarriers [13.5%]) had CKD, 1298 (140 of 675 SCT carriers [20.7%] vs 1158 of 8481 noncarriers [13.7%]) experienced incident CKD, 1719 (150 of 665 SCT carriers [22.6%] vs 1569 of 8249 noncarriers [19.0%]) experienced decline in eGFR, and 1322 (154 of 485 SCT carriers [31.8%] vs 1168 of 5947 noncarriers [19.6%]) had albuminuria during the study period. Individuals with SCT had an increased risk of CKD (odds ratio [OR], 1.57 [95% CI, 1.34-1.84]; absolute risk difference [ARD], 7.6%[95% CI, 4.7%-10.8%]), incident CKD (OR, 1.79 [95% CI, 1.45-2.20]; ARD, 8.5%[95% CI, 5.1%-12.3%]), and decline in eGFR (OR, 1.32 [95% CI, 1.07-1.61]; ARD, 6.1%[95% CI, 1.4%-13.0%]) compared with noncarriers. Sickle cell trait was also associated with albuminuria (OR, 1.86 [95% CI, 1.49-2.31]; ARD, 12.6%[95% CI, 7.7%-17.7%]). CONCLUSIONS AND RELEVANCE Among African Americans in these cohorts, the presence of SCT was associated with an increased risk of CKD, decline in eGFR, and albuminuria, compared with noncarriers. These findings suggest that SCT may be associated with the higher risk of kidney disease in African Americans.
作者
我是这篇论文的作者
点击您的名字以认领此论文并将其添加到您的个人资料中。
推荐
暂无数据