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Publication Information

PubMed ID
Public Release Type
Journal
Publication Year
2024
Affiliation
1Department of Statistics, University of California, Riverside, CA 92521, USA 2Department of Biostatistics, University of California, Los Angeles, CA 90095, USA 3Department of Medicine, University of California Irvine, Orange, CA 92868, USA 4Harold Simmons Center for Chronic Disease Research and Epidemiology, University of California Irvine School of Medicine, Orange, CA 92868, USA
Authors
Banerjee S, Kurum E, Kwan B, Nguyen DV, Qian Q, Rhee CM, Senturk D
Studies

Abstract

early 15% (37 million) of adults in the United States (US) have chronic kidney disease (CKD). The longitudinal trajectory of kidney function decline in patients with CKD is intricately related to the development of cardiovascular disease (CVD) and eventual “terminal” event (kidney failure and mortality). Understanding of the mechanism and risk factors underlying the three key outcome processes, (1) CKD progression, (2) CVD, and (3) subsequent terminal event in the CKD patient population remains incomplete. Thus, in this work, we develop a novel trivariate joint model to study the risk factors associated with the interdependent outcomes of kidney function (as measured by longitudinal estimated glomerular filtration rate), recurrent cardiovascular events, and the terminal event. Efficient estimation and inference is proposed within a Bayesian framework using Markov Chain Monte Carlo and Bayesian P-splines for hazard functions. The proposed Bayesian framework is directly generalizable beyond trivariate outcome processes to accommodate other potential modeling of complex multi-disease processes. The method is applied to study the aforementioned trivariate processes using data from the Chronic Renal Insufficiency Cohort Study, an ongoing prospective cohort study, established by the National Institute of Diabetes and Digestive and Kidney Diseases to address the rising epidemic of CKD in the US.