Mortality risk of chronic kidney disease: A comparison between the adult populations in urban China and the United States

Chronic kidney disease (CKD) is a risk factor for all-cause mortality in the United States, but the evidence from China is limited. We investigate whether prognosis of CKD (mortality) differs between the two countries. In particular, we sought to compare the strength of association between CKD stage...

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Published in:PloS one 2018-03, Vol.13 (3), p.e0193734-e0193734
Main Authors: Wang, Jinwei, Wang, Fang, Saran, Rajiv, He, Zhi, Zhao, Ming-Hui, Li, Yi, Zhang, Luxia, Bragg-Gresham, Jennifer
Format: Article
Language:English
Subjects:
Adults
Albuminuria
Albuminuria - complications
Biology and Life Sciences
Cardiovascular disease
China
Chronic kidney failure
Complications and side effects
Cross-Sectional Studies
Demographic aspects
Diabetes
Epidemiology
Epidermal growth factor receptors
Etiology
Female
Glomerular Filtration Rate
Health aspects
Health care
Health risks
Hospitals
Humans
Internal medicine
Kidney diseases
Kidneys
Male
Medicine and Health Sciences
Meta-analysis
Middle Aged
Mortality
Nephrology
Nutrition
People and Places
Population
Preventive medicine
Prognosis
Proportional Hazards Models
Renal Insufficiency, Chronic - mortality
Renal Insufficiency, Chronic - physiopathology
Risk Factors
Systematic review
Trends
United States
Urban populations
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creator Wang, Jinwei
Wang, Fang
Saran, Rajiv
He, Zhi
Zhao, Ming-Hui
Li, Yi
Zhang, Luxia
Bragg-Gresham, Jennifer
description Chronic kidney disease (CKD) is a risk factor for all-cause mortality in the United States, but the evidence from China is limited. We investigate whether prognosis of CKD (mortality) differs between the two countries. In particular, we sought to compare the strength of association between CKD stage and all-cause mortality, by country. Mortality-linked data from China National Survey of Chronic Kidney Disease (urban population, n = 25,269) and US NHANES (2005-2010, n = 15,209) for adults >20 years old were analyzed. The Chinese cohort was followed until Dec 31, 2013, while the NHANES cohort until Dec 31, 2011. CKD was defined by eGFR
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We investigate whether prognosis of CKD (mortality) differs between the two countries. In particular, we sought to compare the strength of association between CKD stage and all-cause mortality, by country. Mortality-linked data from China National Survey of Chronic Kidney Disease (urban population, n = 25,269) and US NHANES (2005-2010, n = 15,209) for adults &gt;20 years old were analyzed. The Chinese cohort was followed until Dec 31, 2013, while the NHANES cohort until Dec 31, 2011. CKD was defined by eGFR &lt;60ml/min/1.73m2 or albuminuria (defined as ACR ≥30mg/g). Weighted Cox models were used to evaluate the association between the two CKD indicators and mortality. Both stratified and combined models (with country interactions) were explored. The Chinese sample had a lower proportion of eGFR&lt;60 ml/min/1.73m2 (3.7% vs. 6.9%) and albuminuria (7.6% vs. 9.0%), compared to the US. Higher rates of mortality were observed with higher stages of CKD in both countries. HRs for mortality in the more advanced CKD categories reached 2.18 (1.14-4.15) in China and 1.66 (1.18-2.32) in the US in the absence of albuminuria, and 2.30 (1.13-4.68) and 3.04 (2.33-3.96) in the presence of albuminuria. No significant interactions were detected between country and these categories. The association between albuminuria and reduced eGFR and all-cause mortality was similar in both countries, with albuminuria being associated with the larger effect size compared to lower eGFR.</abstract><cop>United States</cop><pub>Public Library of Science</pub><pmid>29543826</pmid><doi>10.1371/journal.pone.0193734</doi><tpages>e0193734</tpages><orcidid>https://orcid.org/0000-0003-0128-8408</orcidid><oa>free_for_read</oa></addata></record>
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subjects Adults
Albuminuria
Albuminuria - complications
Biology and Life Sciences
Cardiovascular disease
China
Chronic kidney failure
Complications and side effects
Cross-Sectional Studies
Demographic aspects
Diabetes
Epidemiology
Epidermal growth factor receptors
Etiology
Female
Glomerular Filtration Rate
Health aspects
Health care
Health risks
Hospitals
Humans
Internal medicine
Kidney diseases
Kidneys
Male
Medicine and Health Sciences
Meta-analysis
Middle Aged
Mortality
Nephrology
Nutrition
People and Places
Population
Preventive medicine
Prognosis
Proportional Hazards Models
Renal Insufficiency, Chronic - mortality
Renal Insufficiency, Chronic - physiopathology
Risk Factors
Systematic review
Trends
United States
Urban populations
title Mortality risk of chronic kidney disease: A comparison between the adult populations in urban China and the United States
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