Table 1.
Summary of studies evaluating risk factors for kidney failure or CKD progression in the CRIC Study
| First Author | Risk Factor | Follow-Up (yr) | n | Association with Outcomes | |
|---|---|---|---|---|---|
| Sociodemographic and economic factors | |||||
| Ricardo et al. (7) | Sex (women versus men) | 6.9 | 3939 | ↓ Kidney failurea risk in women versus men | |
| Fischer et al. (9) | Hispanic ethnicity | 5.1 | 3785 | Similar kidney failure risk in Hispanic versus non-Hispanic White individuals | |
| Ricardo et al. (10) | Nephrologist care | 6.6 | 3855 | No significant association | |
| Behavioral factors | |||||
| Ricardo et al. (11) | Healthy diet, regular physical activity | 4 | 3006 | No significant association | |
| BMI >25 kg/m2, past/never smoker | ↓ Kidney failure risk in overweight/obese and nonsmokers | ||||
| He et al. (15) | ↑ Urinary Na+, K+ | 15,807 p-y | 3939 | ↑ CKD progressionb risk | |
| Hu et al. (20) | Dietary patterns (DASH, aMED, HEI) | 7 | 2403 | ↓ CKD progression risk in least versus most adherent tertile | |
| Hu et al. (21) | Healthy beverage score | 7 | 2283 | ↓ CKD progression risk with higher scores | |
| Bundy et al. (64) | Tobacco, alcohol, marijuana | 5.5 | 2288 | No significant association | |
| Heroin | ↑ CKD progression risk in users versus nonusers | ||||
| Schrauben et al. (65) | Obese/sedentary pattern in adults <65 yr with diabetes | <3 to >5 | 5499 | ↑ CKD progression risk | |
| Ricardo et al. (22) | ↑ Sleep fragmentation | 4.4 | 431 | ↑ eGFR decline and kidney failure risk | |
| ↓ Sleep duration | ↑ eGFR decline | ||||
| Porter et al. (66) | Health-related quality of life | 6.2 | 3837 | No significant association | |
| Cedillo-Couvert et al. (67) | Medication nonadherence | 6 | 3305 | ↑ CKD progression risk | |
| Schrauben et al. (68) | Self-management behaviors (smoking, poor diet, physical inactivity, and uncontrolled BP) | 3 | 3939 | ↑ CKD progression risk | |
| Genetic factors | |||||
| Parsa et al. (26) | APOL1 gene variants | 4.4 | 2955 | ↑ eGFR decline and CKD progression risk | |
| Parsa et al. (28) | SNPs in LINC00923 (RNA gene expressed in the kidney) | — | 3074 | ↑ eGFR decline and kidney failure risk | |
| Wing et al. (69) | DNA methylation pattern | — | 40 | No significant association | |
| Kelly et al. (29) | Renin-angiotensin-aldosterone system genes | — | 3013 | ↑ eGFR decline and CKD progression risk | |
| Cardiovascular factors | |||||
| Bansal et al. (33) | Atrial fibrillation | 5.9 | 3091 | ↑ Kidney failure risk | |
| Anderson et al. (37) | Time-updated ↑ systolic BP | 5.7 | 3708 | ↑ Kidney failure risk | |
| Thomas et al. (70) | Treatment-resistant HTN | 5 | 3367 | ↑ CKD progression risk | |
| Townsend et al. (45) | ↑ Aortic pulse wave velocity | 4.1 | 2795 | ↑ Kidney failure risk | |
| Grunwald et al. (71) | Baseline retinopathy | 2.3 | 1852 | No significant association | |
| Grunwald et al. (72) | Progression of retinopathy | 3.5 | 1936 | No significant association | |
| Kurella Tamura et al. (73) | Cognitive impairment | 6.1 | 3883 | No significant association | |
| Rahman et al. (74) | Self-reported cardiovascular disease | 6.63 | 3939 | No significant association | |
| Self-reported congestive heart failure | 6.63 | 3939 | ↑ CKD progression risk | ||
| Rahman et al. (75) | Lipids | 4.1 | 3939 | No significant association | |
| Metabolic factors | |||||
| Isakova et al. (48) | ↑ FGF23 | 3.5 | 3879 | ↑ Kidney failure risk (depending on baseline stage of CKD) | |
| Dobre et al. (76) | ↓ Serum bicarbonate | 3.9 | 3939 | ↑ CKD progression risk | |
| Scialla et al. (77) | ↓ Net acid excretion | 6 | 980 | ↑ CKD progression risk | |
| Waikar et al. (50) | ↑ Urinary oxalate | 22,318 p-y | 3123 | ↑ CKD progression risk | |
| Koye et al. (78) | Absence of albuminuria in people with diabetes | 6.3 | 1908 | ↓ CKD progression risk versus those with albuminuria and diabetes | |
| Bansal et al. (79) | Body composition by BIA | 7 | 3751 | No significant association | |
| Srivastava et al. (80) | ↑ Uric acid | 7.9 | 3885 | ↑ Kidney failure risk | |
| Novel factors | |||||
| Afshinnia et al. (81) | AA metabolites: 20-HETE, LOX, CYP450 metabolic pathways | 10 | 300 | ↑ Kidney failure risk (20-HETE) | |
| Rhee et al. (82) | Amino acid metabolites, acylcarnitines, dipeptides, nucleotides, and other cationic polar metabolites | — | 400 | Nominally associated with rapid CKD progression | |
| Foster et al. (83) | Serum BTP and B2M | 6 | 3613 | ↑ Kidney failure risk | |
| Inker et al. (84) | BTP and B2M | 13 | 3938 | No significant association | |
| Amdur et al. (85) | ↑ Fibrinogen, ↑ TNF-α, ↓ albumin | 6.3 | 899 | ↑ CKD progression risk | |
| Liu et al. (55) | ↑ Urinary NGAL | 3.2 | 3386 | ↑ CKD progression risk | |
| Hsu et al. (56) | Urine biomarkers (KIM-1, NGAL, NAG, and FABP) | 9433 p-y | 2466 | No independent association | |
| Hsu et al. (54) | AKI | 9433 p-y | 456 | ↑ Urine protein-creatinine ratio | |
| Orlandi et al. (86) | Hematuria | 2 | 3272 | ↑ CKD progression risk | |
| Zhan et al. (87) | Opioid, NSAID use | 6.8 | 3939 | ↑ CKD progression risk, stronger with opioid use than NSAID use | |
| Anderson et al. (88) | CXCL12, NTproBNP, urine NGAL | 7 | 3379 | ↑ CKD progression risk in those with diabetes | |
| ↓ Serum bicarbonate, ↑ hsTnT, NTproBNP, urine NGAL | ↑ CKD progression risk in those without diabetes | ||||
CRIC, Chronic Renal Insufficiency Cohort; BMI, body mass index; Na+, sodium ion; K+, potassium ion; p-y, person years; DASH, Dietary Approaches to Stop Hypertension; aMED, Alternate Mediterranean Diet; HEI, Healthy Eating Index; SNP, single-nucleotide polymorphism; HTN, hypertension; FGF23, fibroblast growth factor 23; BIA, bioelectrical impedance analysis; AA, amino acid; 20-HETE, 20-hydroxyeicosatetraenoic acid; CYP450, cytochrome P450; BTP, β-trace protein; B2M, β-2 microglobulin; NGAL, neutrophil gelatinase-associated lipocalin; KIM-1, kidney injury molecule 1; NAG, N-acetyl-β-d-glucosaminidase; FABP, liver fatty acid binding protein; NSAID, nonsteroidal anti-inflammatory drug; CXCL12, inflammatory chemokine; NTproBNP, N-terminal pro-B-type natriuretic peptide; hsTnT, high-sensitivity troponin T.
a
Kidney failure defined as receipt of RRT (dialysis or kidney transplant).
b
CKD progression defined as kidney failure or 50% reduction of eGFR from baseline.