Table 2.
Hazard ratios (HRs) and 95% confidence intervals (CIs) for associations of annual change in urinary albumin-to-creatinine ratio (UACR) with incidence of stage 4 to 5 chronic kidney disease (CKD), end-stage renal disease (ESRD), cardiovascular disease (CVD), and deatha
| Annual change in UACR | Basic adjustment, complete datab |
Full adjustment, complete data |
Full adjustment + imputationb |
|||||
|---|---|---|---|---|---|---|---|---|
| Events | n | HR (95% CI) | Events | n | HR (95% CI) | HR (95% CI) | ||
| Stage 4 to 5 CKD | 2621 | 89,360 | 2297 | 77,981 | ||||
| >2-fold decrease | 113 | 3066 | 0.52 (0.43–0.64) | 100 | 2588 | 0.62 (0.50–0.77) | 0.59 (0.48–0.72) | |
| >1.3–2 fold decrease | 394 | 13,620 | 0.74 (0.66–0.82) | 341 | 11,752 | 0.76 (0.67–0.86) | 0.76 (0.68–0.86) | |
| Stable | 1243 | 51,345 | 1.0 | 1091 | 44,962 | 1.0 | 1.0 | |
| >1.3–2 fold increase | 648 | 16,976 | 1.93 (1.75–2.12) | 576 | 14,884 | 1.77 (1.60–1.96) | 1.75 (1.59–1.93) | |
| >2-fold increase | 223 | 4353 | 3.43 (2.97–3.96) | 189 | 3795 | 2.68 (2.29–3.14) | 2.90 (2.51–3.36) | |
| ESRD | 162 | 89,360 | 149 | 77,981 | ||||
| >2-fold decrease | 6 | 3066 | 0.38 (0.16–0.89) | 4 | 2588 | 0.29 (0.10–0.81) | 0.40 (0.17–0.95) | |
| >1.3–2 fold decrease | 27 | 13,620 | 0.86 (0.54–1.36) | 26 | 11,752 | 0.89 (0.56–1.43) | 0.88 (0.56–1.40) | |
| Stable | 59 | 51,345 | 1.00 | 56 | 44,962 | 1.0 | 1.0 | |
| >1.3–2 fold increase | 43 | 16,976 | 3.34 (2.25–4.97) | 39 | 14,884 | 2.90 (1.92–4.39) | 3.03 (2.03–4.51) | |
| >2-fold increase | 27 | 4353 | 12.15 (7.64–19.31) | 24 | 3795 | 9.67 (5.92–15.78) | 10.64 (6.67–16.98) | |
| CVD | 7041 | 67,506 | 6199 | 57,963 | ||||
| >2-fold decrease | 223 | 2365 | 0.61 (0.53–0.71) | 199 | 1962 | 0.67 (0.58–0.78) | 0.63 (0.55–0.73) | |
| >1.3–2 fold decrease | 1051 | 10,420 | 0.79 (0.74–0.85) | 909 | 8824 | 0.80 (0.74–0.86) | 0.80 (0.75–0.86) | |
| Stable | 4042 | 39,384 | 1.00 | 3567 | 33,985 | 1.0 | 1.0 | |
| >1.3–2 fold increase | 1378 | 12,286 | 1.22 (1.15–1.30) | 1216 | 10,577 | 1.21 (1.13–1.29) | 1.21 (1.14–1.29) | |
| >2-fold increase | 347 | 3051 | 1.47 (1.32–1.65) | 308 | 2615 | 1.46 (1.30–1.64) | 1.44 (1.29–1.61) | |
| Death | 9949 | 92,854 | 8807 | 80,782 | ||||
| >2-fold decrease | 425 | 3267 | 0.78 (0.71–0.87) | 370 | 2743 | 0.85 (0.77–0.95) | 0.85 (0.76–0.94) | |
| >1.3–2 fold decrease | 1504 | 14,127 | 0.85 (0.81–0.91) | 1314 | 12,151 | 0.88 (0.82–0.93) | 0.88 (0.83–0.94) | |
| Stable | 5027 | 52,989 | 1.00 | 4479 | 46,273 | 1.0 | 1.0 | |
| >1.3–2 fold increase | 2204 | 17,782 | 1.42 (1.35–1.50) | 1942 | 15,542 | 1.33 (1.26–1.40) | 1.35 (1.29–1.42) | |
| >2-fold increase | 789 | 4689 | 2.31 (2.14–2.49) | 702 | 4073 | 2.09 (1.92–2.26) | 2.12 (1.96–2.28) | |
Basic and full adjustments include sex, baseline age, fifths of deprivation. Full adjustment also includes previous cardiovascular disease, previous diabetes, current smoking, systolic blood pressure, total cholesterol, estimated glomerular filtration rate (spline knot at 60 ml/min per 1.73 m2), and baseline loge−urinary albumin-to-creatinine ratio (UACR). Those with prevalent stage 4 to 5 CKD or end-stage renal disease were excluded from analyses with outcomes of stage 4 to 5 CKD or CVD. For analyses of the CVD outcome, individuals with prevalent CVD were also excluded.
Change in UACR was estimated over a 3-year exposure window
Missing systolic blood pressure, total cholesterol, and eGFR were imputed using multiple imputation. There were no missing data for the basic adjustment, so numbers of events and individuals are the same as for the full adjustment with imputation.