TABLE 2.
Crude and multivariable associations with ESRD in the setting of the competing risk of pre-ESRD death, from five starting thresholds
| eGFR 30 ml/min/1.73m2 | eGFR 15 ml/min/1.73m2 | 1-y ESRD risk 5% | 1-y ESRD risk 10% | 1-y ESRD risk 20% | ||||||
|---|---|---|---|---|---|---|---|---|---|---|
| Crude Associations (adjusted only for eGFR or 1-y probability of ESRD) | ||||||||||
| Covariate | sHR (95% CI) | P | sHR (95% CI) | P | sHR (95% CI) | P | sHR (95% CI) | P | sHR (95% CI) | P |
| Age, per 10-y older | 0.69 (0.63–0.77) | <0.001 | 0.88 (0.77–1.01) | 0.08 | 0.92 (0.83–1.03) | 0.1 | 0.99 (0.88–1.11) | 0.9 | 1.15 (0.99–1.32) | 0.06 |
| Male sex | 1.09 (0.87–1.38) | 0.5 | 1.11 (0.83–1.48) | 0.5 | 1.10 (0.87–1.40) | 0.4 | 1.11 (0.87–1.43) | 0.4 | 1.11 (0.83–1.47) | 0.5 |
| BMI, per 5 kg/m2 greater | 1.11 (1.02–1.20) | 0.01 | 0.98 (0.88–1.08) | 0.6 | 1.00 (0.92–1.09) | 0.9 | 0.96 (0.88–1.04) | 0.3 | 0.93 (0.85–1.02) | 0.1 |
| SBP, per 10-mmHg greater | 1.08 (1.04–1.13) | <0.001 | 1.01 (0.94–1.09) | 0.8 | 1.01 (0.97–1.06) | 0.6 | 1.00 (0.95–1.06) | 0.9 | 0.99 (0.93–1.06) | 0.8 |
| ACR, per 2-fold higher | 1.41 (1.32–1.50) | <0.001 | 1.29 (1.16–1.43) | <0.001 | 1.08 (0.98–1.18) | 0.1 | 0.94 (0.83–1.06) | 0.3 | 0.91 (0.78–1.06) | 0.2 |
| APOL1 high-risk status | 1.92 (1.45–2.55) | <0.001 | 1.10 (0.77–1.58) | 0.6 | 1.47 (1.11–1.95) | 0.007 | 1.28 (0.96–1.70) | 0.09 | 1.05 (0.74–1.47) | 0.8 |
| Antecedent eGFR decline, per 5-ml/min/1.73 m2 per y faster | 1.15 (1.09–1.21) | <0.001 | 1.19 (0.99–1.44) | 0.07 | 1.06 (0.99–1.13) | 0.09 | 1.06 (0.99–1.13) | 0.08 | 1.05 (0.97–1.13) | 0.2 |
| Rapid eGFR progression | 1.67 (1.23–2.28) | 0.001 | 1.26 (0.93–1.70) | 0.1 | 1.13 (0.82–1.56) | 0.5 | 1.20 (0.89–1.60) | 0.2 | 1.15 (0.86–1.54) | 0.3 |
| Multivariable Associations (also adjusted for eGFR or 1-y probability of ESRD) | ||||||||||
| Age, per 10-y older | 0.75 (0.62–0.90) | 0.002 | 0.91 (0.75–1.09) | 0.3 | 0.97 (0.79–1.19) | 0.8 | 1.07 (0.91–1.26) | 0.4 | 1.26 (1.02–1.55) | 0.03 |
| Male sex | 1.49 (0.96–2.31) | 0.08 | 1.07 (0.69–1.67) | 0.8 | 0.96 (0.65–1.41) | 0.8 | 0.92 (0.63–1.34) | 0.7 | 0.65 (0.43–1.00) | 0.05 |
| BMI, per 5-kg/m2 greater | 0.96 (0.85–1.08) | 0.5 | 0.90 (0.80–1.01) | 0.06 | 0.97 (0.86–1.10) | 0.6 | 1.02 (0.92–1.12) | 0.7 | 0.97 (0.88–1.07) | 0.6 |
| SBP, per 10-mm Hg greater | 1.08 (0.96–1.20) | 0.2 | 0.90 (0.81–0.99) | 0.03 | 1.02 (0.92–1.12) | 0.7 | 0.99 (0.91–1.08) | 0.9 | 0.98 (0.90–1.07) | 0.6 |
| ACR, per 2-fold higher | 1.36 (1.20–1.54) | <0.001 | 1.40 (1.22–1.62) | <0.001 | 1.13 (0.99–1.28) | 0.08 | 0.98 (0.82–1.17) | 0.8 | 0.87 (0.69–1.08) | 0.2 |
| APOL1 high-risk status | 1.26 (0.82–1.96) | 0.3 | 0.82 (0.56–1.21) | 0.3 | 1.36 (0.93–2.00) | 0.1 | 1.26 (0.90–1.76) | 0.2 | 1.01 (0.70–1.44) | 0.9 |
| Antecedent eGFR decline. per 5-ml/min/1.73 m2 per y faster | 1.10 (0.97–1.24) | 0.1 | 1.06 (0.97–1.15) | 0.2 | 1.03 (0.95–1.12) | 0.5 | 1.07 (0.93–1.23) | 0.4 | 1.01 (0.94–1.09) | 0.8 |
Note: Minimally-adjusted analyses represents competing risk regression of the risk of ESRD associated with the covariate, adjusting for eGFR in the analyses using eGFR thresholds and 1-y ESRD risk in the analyses of ESRD risk thresholds.28 Multivariable associations reflect competing risk regression of the risk of ESRD associated with all specified covariates as well as eGFR in the analyses using eGFR thresholds and 1-year ESRD risk in the analyses of ESRD risk thresholds. In all regressions, pre-ESRD death is treated as a competing event. Baseline for each analysis is the first study visit at which a participant crosses the specified threshold (eGFR 30 or 15 ml/min/1.73 m2, 1-year ESRD risk of 5%, 10%, or 20%).
ACR, albumin-creatinine ratio; BMI, body mass index; PCR, protein-creatinine ratio; eGFR, estimated glomerular filtration rate; ESRD, end-stage renal disease; sHR indicates sub-distribution hazard ratio ; CI, confidence interval; SBP, systolic blood pressure