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CKD in Hispanics: Baseline characteristics from the CRIC (Chronic Renal Insufficiency Cohort) and Hispanic-CRIC
Michael J Fischer1, Alan S Go, Claudia M Lora
1Jesse Brown VA Medical Center, Chicago, IL, USA. fischerm@uic.edu
Insights
Hispanics with chronic kidney disease (CKD) face greater challenges, including lower socioeconomic status, higher diabetes rates, and less medication use. They also experience worse blood pressure control and more severe CKD complications compared to non-Hispanics.
Area of Science:
- Nephrology
- Public Health
- Health Disparities
Background:
- Chronic kidney disease (CKD) prevalence and characteristics in Hispanic populations remain understudied.
- Understanding disparities in CKD is crucial for targeted interventions.
Purpose of the Study:
- To compare baseline characteristics of Hispanic participants in the Chronic Renal Insufficiency Cohort (CRIC) and Hispanic-CRIC (H-CRIC) studies with non-Hispanic CRIC participants.
- To identify specific health burdens and treatment differences in Hispanic individuals with CKD.
Main Methods:
- Cross-sectional analysis of participants aged 21-74 years with CKD.
- Comparison of demographic, clinical, and medication data between Hispanic and non-Hispanic participants.
- Assessment of race/ethnicity, socioeconomic factors, comorbidities, blood pressure, and kidney function markers.
Main Results:
- Hispanics exhibited significantly lower income and educational attainment compared to non-Hispanics.
- Self-reported diabetes was more prevalent in Hispanics (67%) than non-Hispanic blacks (51%) and whites (40%).
- Hispanics showed higher rates of uncontrolled blood pressure (>130/80 mm Hg), more hematologic/metabolic/bone abnormalities, lower estimated glomerular filtration rate (eGFR), and higher proteinuria.
- Use of angiotensin-converting enzyme (ACE)-inhibitor/angiotensin receptor blocker (ARB) medications was lowest among Hispanics, even in high-risk subgroups.
Conclusions:
- Hispanic individuals with CKD are disproportionately affected by socioeconomic disadvantages, higher diabetes prevalence, and poorer CKD management.
- Observed disparities include less optimal blood pressure control, more severe kidney disease, and underutilization of key medications like ACE inhibitors/ARBs.
- Findings highlight significant health inequities faced by Hispanics with CKD, warranting further investigation and tailored healthcare strategies.
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 & Participants:
Participants were aged 21-74 years with CKD using age-based estimated glomerular filtration rate (eGFR) at enrollment into the CRIC/H-CRIC Studies. H-CRIC included Hispanics recruited at the University of Illinois in 2005-2008, whereas CRIC included Hispanics and non-Hispanics recruited at 7 clinical centers in 2003-2007.
Factor:
Race/ethnicity.
Outcomes:
Blood pressure, angiotensin-converting enzyme (ACE)-inhibitor/angiotensin receptor blocker (ARB) use, and CKD-associated complications.
Measurements:
Demographic characteristics, laboratory data, blood pressure, and medications were assessed using standard techniques and protocols.
Results:
Of H-CRIC/CRIC participants, 497 were Hispanic, 1,650 were non-Hispanic black, and 1,638 were non-Hispanic white. Low income and educational attainment were nearly twice as prevalent in Hispanics compared with non-Hispanics (P < 0.01). Hispanics had self-reported diabetes (67%) more frequently than non-Hispanic blacks (51%) and whites (40%; P < 0.01). Blood pressure >130/80 mm Hg was more common in Hispanics (62%) than blacks (57%) and whites (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. Hispanics had the lowest use of ACE inhibitors/ARBs among the high-risk subgroups, including participants with diabetes, proteinuria, and blood pressure >130/80 mm Hg. Mean eGFR was lower in Hispanics (39.6 mL/min/1.73 m(2)) than in blacks (43.7 mL/min/1.73 m(2)) and whites (46.2 mL/min/1.73 m(2)), whereas median proteinuria was higher in Hispanics (protein excretion, 0.72 g/d) than in blacks (0.24 g/d) and whites (0.12 g/d; P < 0.01).
Limitations:
Generalizability; observed associations limited by residual bias and confounding.
Conclusions:
Hispanics with CKD in the CRIC/H-CRIC Studies are disproportionately burdened with lower socioeconomic status, more frequent diabetes mellitus, less ACE-inhibitor/ARB use, worse blood pressure control, and more severe CKD and associated complications than their non-Hispanic counterparts.
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