The incidence of CKD stages 3-5 through 9 years of follow-up among 45- to 64-year old ARIC participants was 10.4 per 1,000 person-years.
Incidence was higher among older, white, and female participants, and double among those with diabetes or hypertension, relative to those without these conditions.
Chart Explanation: Over 9 years of follow-up in the Atherosclerosis Risk in Communities (ARIC) Study, the rate of incidence of CKD stages 3-5 (among those with eGFR >60 ml/min/1.73 m² at baseline) was 10.4 per 1,000 person-years. The incidence rate of CKD stages 3-5 was much higher in those who were ≥60 vs. <60 years old at the start of the study: 21.8 vs. 7.4 per 1,000 person-years (P<0.001). Females had higher incidence rates (11.0 vs. 9.6 per 1,000 person-years (P<0.001) than males, and white participants had higher rates (10.8 vs. 8.9 per 1,000 person-years; P<0.001) than black participants. As expected, participants with diabetes had nearly double the CKD incidence of ARIC participants without diabetes: 18.9 vs. 9.5 per 1,000 person-years (P<0.001). Similarly, participants with hypertension had double the CKD incidence compared to participants without hypertension: 16.7 vs. 7.5 per 1,000 person-years (P<0.001).
The Atherosclerosis Risk in Communities (ARIC) Study is a longitudinal cohort study of 15,792 participants aged 45-64 recruited from four U.S. suburban communities (Forsyth County, NC; Jackson, MS; suburban Minneapolis, MN; and Washington County, MD) with a primary purpose of investigating the etiology and natural history of atherosclerosis. As with all cohort studies, participants may not be representative of all those who live in the communities from which they are recruited, or elsewhere.
Measurements of creatinine, from which CKD stages 3-5 were defined, were taken at the baseline, 3-year, and 9-year visits in ARIC participants. Incidence was calculated as the number of ARIC participants with CKD (eGFR <60 ml/min/1.73 m²) at a follow-up visit, divided by the total number of ARIC participants without CKD at baseline (eGFR ≥60 ml/min/1.73 m²) and the total follow-up time (to death, censoring, or development of CKD) contributed by these participants.
|Description of Measure||Incidence of CKD stages 3-5|
|Type of Data Source||Private|
|Data Set||ARIC baseline, 3 & 9 years|
|Health Care System Data||No|
|Regional or National?||Regional (Forsyth County, NC; Jackson, MS; suburban Minneapolis, MN; and Washington County, MD)|
|Demographic Group||U.S. residents aged 45-64 years and living in one of four targeted communities.|
|Numerator||ARIC participants with CKD (as measured by eGFR) at follow-up|
|Denominator||Individuals between the ages of 45 and 64 recruited for ARIC study with baseline eGFR ≥60 ml/min/1.73 m²|
|Definition of CKD||eGFR <60 ml/min/1.73 m² (stages 3-5 only)|
|Glomerular filtration rate||Estimated using MDRD study formula for standardized serum creatinine: eGFR=175 × [(calibrated serum creatinine in mg/dl)⁻¹˙¹⁵⁴] × age⁻⁰˙²⁰³ × (0.742 if female) × (1.210 if African-American)|
|Primary Data Source Indicator||Serum creatinine (BL, 3- and 9-yr follow-up)|
|Primary Indicator Method of Measurement||Examination/Laboratory|
|Secondary (1) Variable||Age in years|
|Secondary (1) Indicator Method of Measurement||Questionnaire (self-report)|
|Secondary (2) Variable||Gender|
|Secondary (2) Indicator Method of Measurement||Questionnaire (self-report)|
|Secondary (3) Variable||Race/ethnicity|
|Secondary (3) Indicator Method of Measurement||Questionnaire (self-report)|
|Frequency of Measurement (Primary)||Three measurements (cross-sectional)|
|U.S. Region Covered by Primary Variable||See four study sites, above|
|Period Currently Available||1987–1998|
|Pending Data||Future ARIC visits in subset (pending funding)|
|Additional Data Items of Interest||Stage of CKD, other stratification variables of interest (diabetes by self-report/use of meds/fasting glucose, hypertension by self-report/BP)|
|Limitations of Indicator||Proteinuria data @ 4 years only|
|Analytical Considerations||Adjustment for race/ethnicity X study site; To calibrate creatinine in ARIC: -0.24 for visits 1 & 2 and .18 for visit 4, then multiplied by 0.95|
References and Sources:
Bash LD, Coresh J, Köttgen A, et al. Defining chronic kidney disease in the research setting: the Atherosclerosis Risk in Communities (ARIC) Study. Am J Epidemiol. 2009;170(4):414-24.