Indicator Details — Native Americans: Crude Incidence of CKD
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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.
FieldData
Description of MeasureIncidence of CKD
Data SourceStrong Heart Study
Type of Data SourcePrivate
Data SetSHS
Health Care System DataNo
Regional or National?National
Demographic GroupAmerican Indians aged 45-74 from 13 tribes/communities
NumeratorNumber of participants with newly detected CKD at third exam
DenominatorAll participants free of CKD at baseline exam
Definition of CKDNo 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 m
Glomerular filtration rateCalculated by MDRD-4 Study equation
Primary Data Source IndicatorRate of newly detected CKD at third study exam, as indicated by study measurement of serum creatinine and urine albumin:creatinine ratio
Primary Indicator Method of MeasurementLaboratory
Frequency of Measurement (Primary)Once (cross-sectional at third exam)
U.S. Region Covered by Primary VariableArizona, Oklahoma, and the Dakotas
Period Currently Available1989–1999
Pending DataPossible continued passive follow-up only
Additional Data Items of InterestAge, gender, diabetes, hypertension
Limitations of IndicatorLoss to follow-up may introduce bias into the measurement of incident CKD
Analytical ConsiderationsAnalysis performed by SHS investigators; denominators for each study exam and indicator must be defined properly
Suggested Citation:
Centers for Disease Control and Prevention. Chronic Kidney Disease Surveillance System—United States.
website. http://www.cdc.gov/ckd