Chronic Kidney Disease in Hispanics: Baseline Characteristics from the Chronic Renal Insufficiency Cohort (CRIC) and Hispanic-CRIC Studies

Fischer M, Go A, Lora CM, Ackerson L, Cohan J, Kusek J, Mercado A, Ojo A, Ricardo A, Tao K, Xie D, Feldman H, Lash JP. Chronic Kidney Disease in Hispanics: Baseline Characteristics from the Chronic Renal Insufficiency Cohort (CRIC) and Hispanic-CRIC Studies. Paper presented at: Chronic Renal Insufficiency Annual Symposium; 2011 Feb 1; Baltimore, MD.

Related HSR&D Project(s)

• CDA 06-018 – Role of Kidney Disease in an Elderly High-risk Population

Background: Little is known regarding chronic kidney disease (CKD) in Hispanics. We compared baseline characteristics of Hispanic participants in the Chronic Renal Insufficiency Cohort (CRIC) and Hispanic-CRIC (H-CRIC) Studies with non-Hispanic CRIC participants. Study Design: Cross-sectional analysis Setting and Participants: Participants were aged 21-74 years with CKD using age-based glomerular filtration rate (eGFR) at enrollment into the H-CRIC and CRIC Studies . H-CRIC included Hispanics recruited at the University of Illinois from 2005-2008 while CRIC included Hispanics and non-Hispanics recruited at seven clinical centers from 2003-2007. Factor: Race/ethnicity Outcomes: Blood pressure, angiotensin-converting enzyme inhibitor (ACE-I)/angiotensin receptor blocker (ARB) use, CKD-associated complications Measurements: Demographic characteristics, laboratory data, blood pressure, and medications were assessed using standard techniques and protocols Results: Among H-CRIC and CRIC participants, 496 were Hispanic, 1651 non-Hispanic Black, and 1638 non-HispanicWhite. Low income and educational attainment were nearly twice as prevalent in Hispanics compared with non-Hispanics (p = 0.0001). While Hispanics had self-reported diabetes (67%) more frequently than non-Hispanic Blacks (51%) and Whites (40%) (p = 0.0001), they had a lower receipt of ACE-I or ARB. Mean eGFR (ml/min/m2) was lower in Hispanics (37.5) than in Blacks (43.5) and Whites (43.7), while median proteinuria (g/d) was higher in Hispanics (0.72) than in Blacks (0.24) andWhites (0.12) (p < 0.001). Blood pressure > 130/80 mmHg was more common in Hispanics (62%) compared with Blacks (57%) andWhites (35%) (p < 0.05), and abnormalities in hematologic, metabolic, and bone metabolism parameters were more prevalent in Hispanics (p < 0.05), even after stratifying by entry eGFR. Limitations: Generalizability of findings; observed associations limited by residual bias and confounding Conclusions: Hispanics with CKD are disproportionately burdened with lower socioeconomic status, more frequent diabetes mellitus, less ACE-I/ARB use, worse blood pressure control, and more severe CKD and associated complications than their non-Hispanic counterparts.