Crude incidence of CKD was high in this cohort, with the risk of developing CKD being 4.8 per 100 person-years; older and female participants, and those with diabetes and hypertension, were at higher risk of developing CKD
Chart Explanation: The overall crude incidence of CKD in those free of CKD at the baseline exam was 4.8 per 100 person-years. Of those who developed CKD by the third exam, 27% had stages 3-5 CKD, while 40% and 33% had stages 1 and 2 CKD, respectively (not shown in figure). Crude incidence of CKD was higher among those who were older, females, and those with diabetes and hypertension.
The Strong Heart Study consisted of several components and three study exams (baseline, 1989-1992; second exam, 1993-1995; and third exam, 1998-1999), followed by morbidity and mortality surveillance of 4,500 tribal participants. Strong Heart enrolled men and women aged 45-74 at baseline from 13 American Indian tribes/communities in Arizona, Oklahoma, and the Dakotas. A total of 4,337 Strong Heart participants had baseline serum creatinine and urine albumin:creatinine ratio (ACR) measurements. CKD was defined by ACR >30mg/g or eGFR <60 ml/min/1.73 m2 by the 4-parameter MDRD Study equation. Of those free of CKD at baseline (n=2,472), incidence of CKD at the third exam (up to 10 years of follow-up) was calculated.
| Field | Data |
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| Description of Measure | Incidence of CKD
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| Data Source | Strong Heart Study
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| Type of Data Source | Private
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| Data Set | SHS
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| Health Care System Data | No
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| Regional or National? | National
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| Demographic Group | American Indians aged 45-74 from 13 tribes/communities
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| Numerator | Number of participants with newly detected CKD at third exam
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| Denominator | All participants free of CKD at baseline exam
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| Definition of CKD | No CKD, eGFR >90 ml/min/1.73 m2 & albumin:creatinine ratio <30 mg/g
Stage 1, eGFR >90 ml/min/1.73 m2 & albumin:creatinine ratio >30 mg/g
Stage 2, eGFR 60-89 ml/min/1.73 m2 & albumin:creatinine ratio >30 mg/g
Stages 3-5, eGFR <60 ml/min/1.73 m2
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| Glomerular filtration rate | Calculated by MDRD-4 Study equation
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| Primary Data Source Indicator | Rate of newly detected CKD at third study exam, as indicated by study measurement of serum creatinine and urine albumin:creatinine ratio
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| Primary Indicator Method of Measurement | Laboratory
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| Frequency of Measurement (Primary) | Once (cross-sectional at third exam)
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| U.S. Region Covered by Primary Variable | Arizona, Oklahoma, and the Dakotas
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| Period Currently Available | 1989–1999 |
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| Pending Data | Possible continued passive follow-up only
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| Additional Data Items of Interest | Age, gender, diabetes, hypertension |
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| Limitations of Indicator | Loss to follow-up may introduce bias into the measurement of incident CKD
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| Analytical Considerations | Analysis performed by SHS investigators; denominators for each study exam and indicator must be defined properly
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