Indicator Details — Native Americans: Age- and Gender-adjusted Incidence of Cardiovascular Mortality by CKD
Data Sources
 
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  Source
  • SHS

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Age- and gender-adjusted incidence of cardiovascular mortality over nearly 20 years was higher for those with CKD, compared to those without CKD, regardless of other characteristics
Older age, male gender, and having diabetes or hypertension remained associated with greater incidence of cardiovascular mortality over time, in those with and without CKD, with adjustment of rates for age and gender
Chart Explanation: Even with adjustment for age and gender, incidence of cardiovascular mortality was higher for those with CKD, compared to those without CKD, regardless of subgroup. Older age, male gender, and having diabetes and hypertension remained associated with greater incidence of cardiovascular mortality, with adjustment, over time in those with and without CKD.
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 1,801 Strong Heart participants had both baseline information on both kidney function (eGFR) and albuminuria (albumin:creatinine ratio) and information on mortality status and cause through December 2007, ascertained through medical records and death certificates. CKD was defined by ACR >30mg/g or eGFR <60 ml/min/1.73 m2 by the 4-parameter MDRD Study equation. Mortality rates were adjusted for age and gender, as appropriate.
FieldData
Description of MeasureAge- and gender-adjusted incidence of cardiovascular mortality
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 dying of cardiovascular causes by 12/31/07
DenominatorAll participants at baseline exam & follow-up time (person-years)
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
ProteinuriaSpot urine albumin:creatinine ratio
Primary Data Source IndicatorRate of dying of cardiovascular causes, assessed by medical record review
Primary Indicator Method of MeasurementMedical Record
Frequency of Measurement (Primary)Ongoing
U.S. Region Covered by Primary VariableArizona, Oklahoma, and the Dakotas
Period Currently Available1989–2007
Pending DataPossible continued passive follow-up only
Additional Data Items of InterestAge, gender, diabetes, hypertension
Limitations of IndicatorLoss to follow-up in active follow-up phases
Analytical ConsiderationsAnalysis performed by SHS investigators; denominators for each study exam and indicator must be defined properly; censoring for death due to other causes
Suggested Citation:
Centers for Disease Control and Prevention. Chronic Kidney Disease Surveillance System—United States.
website. http://www.cdc.gov/ckd