PubMed ID:
36128489
Public Release Type:
Journal
Publication Year: 2022
Affiliation: Division of Nephrology, Seattle Children's Hospital, and Department of Pediatrics, University of Washington, Seattle, Washington; Division of Nephrology, Kidney Research Institute, University of Washington, Seattle, Washington, USA.
DOI:
https://doi.org/10.34067/KID.0006712021
Authors:
Prince D,
Kula A,
Young B,
Bansal N,
Limonte C
Request IDs:
3188
Studies:
Chronic Renal Insufficiency Cohort Study
In studies of older adults with chronic kidney disease (CKD), the risk for cardiovascular (CV) disease and progression to end-stage kidney disease (ESKD) are significantly higher for Black and Hispanic individuals compared with patients of other racial and ethnic groups1-3. The reason underlying these disparities are thought to be in part biological from genetic variants such as APOL1, but also largely due to social determinants of health4. Health status in adulthood is centrally influenced by the experiences and conditions present at birth, during childhood and through adolescence. Young adulthood (~18-40 years of age) represents the summation of these early life circumstances, and as such, represents the foundation of upon which individuals derive their health into adulthood. However, data on kidney and cardiovascular outcomes in young adults with CKD across race and ethnic groups remains limited. Studies in young adults without CKD demonstrate racial and ethnic disparities in health care outcomes. In the CARDIA study, which enrolled young adults 18-30yrs without CKD, Black participants were more likely to have abnormal findings on echocardiogram, be diagnosed with heart failure before the age of 50, and experience an increased burden of heart failure over a lifetime compared to white participants5-7. Moreover, the rate of glomerular filtration rate (GFR) decline and CKD diagnoses was greater in Black participants compared to participants of white race1. More broadly, individuals who reported receiving higher rates of discrimination were more likely to have poor cardiovascular health and, many of the associations between race and ethnicity with CV disease were attenuated by inclusion of socioeconomic indices5, 8. Study of clinical outcomes across race and ethic groups in young adults with CKD may identify an opportunity for interventions to reduce the disproportionate burden of adverse kidney and cardiovascular outcomes in this populations prior to progressing to older age. Given the longevity of young-adult patients with CKD, any risk factors or disparities left undressed have the potential to compound over a lifetime. As such, the objective of our analysis is to determine the rates of CV events and CKD progression in young adults with CKD overall and across race/ethnic groups.