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.

译文

背景:对于西班牙裔的慢性肾脏疾病(CKD)知之甚少。我们将慢性肾功能不全队列(CRIC)和西班牙裔CRIC(H-CRIC)研究中的西班牙裔参与者的基线特征与非西班牙裔CRIC参与者进行了比较。
研究设计:横断面分析。
地点和参与者:参加CRIC / H-CRIC研究时,使用基于年龄的估计肾小球滤过率(eGFR)对CKD年龄在21-74岁的参与者。 H-CRIC包括2005-2008年在伊利诺伊大学招募的西班牙裔,而CRIC包括2003-2007年在7个临床中心招募的西班牙裔和非西班牙裔。
因素:种族/民族。
结果:血压,血管紧张素转换酶(ACE)抑制剂/血管紧张素受体阻滞剂(ARB)的使用以及与CKD相关的并发症。
测量:使用标准技术和方案评估人口统计学特征,实验室数据,血压和用药。
结果:在H-CRIC / CRIC参与者中,有497名是西班牙裔,有1,650名是非西班牙裔黑人,有1,638名是非西班牙裔白人。与非西班牙裔美国人相比,低收入和受教育程度是西班牙裔美国人的近两倍(P <0.01)。西班牙裔人的自我报告型糖尿病(67%)的发生率高于非西班牙裔黑人(51%)和白人(40%; P <0.01)。血压> 130/80 mm Hg在西班牙裔中更为常见(62%),比黑人(57%)和白人(35%; P <0.05)高,并且血液学,代谢和骨代谢参数异常在西班牙裔中更为普遍(P <0.05),甚至在通过条目eGFR进行分层后也是如此。在高危亚组中,包括糖尿病,蛋白尿和血压> 130/80 mm Hg的参与者中,西班牙裔患者使用ACE抑制剂/ ARB的比例最低。西班牙裔(39.6 mL / min / 1.73 m(2))的平均eGFR低于黑人(43.7 mL / min / 1.73 m(2))和白人(46.2 mL / min / 1.73 m(2)),而中位数西班牙裔的蛋白尿(蛋白排泄,0.72 g / d)高于黑人(0.24 g / d)和白人(0.12 g / d; P <0.01)。
局限性:通用性;观察到的关联受残余偏差和混淆的限制。
结论:CRIC / H-CRIC研究中患有CKD的西班牙人与非糖尿病患者相比,其社会经济地位较低,糖尿病更为频繁,使用ACE抑制剂/ ARB较少,血压控制更差,CKD和相关并发症更为严重,从而承担了不成比例的负担。西班牙裔同行。

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