Wald tests for interactions. p-values for interactions between albuminuria, diabetes, eGFR and hematuria for the Cox-Proportional Hazards Models detailed in Table 2. (DOCX 637Â kb

Chi-yuan Hsu

Geetha Krishnan

Harold I. Feldman

Hernan Rincon-Choles

Hsiang-Yu Chen

James H. Sondheimer

Jason Roy

Jiang He

John T. Daugirdas

John W. Kusek

L. Lee Hamm

Michael J. Fischer

Naohiko Fujii

Paula F. Orlandi

Raymond Townsend

Tariq Shafi

the CRIC Study Investigators

BMC Nephrology

Abstract Background Hematuria is associated with chronic kidney disease (CKD), but has rarely been examined as a risk factor for CKD progression. We explored whether individuals with hematuria had worse outcomes compared to those without hematuria in the CRIC Study. Methods Participants were a racially and ethnically diverse group of adults (21 to 74 years), with moderate CKD. Presence of hematuria (positive dipstick) from a single urine sample was the primary predictor. Outcomes included a 50% or greater reduction in eGFR from baseline, ESRD, and death, over a median follow-up of 7.3 years, analyzed using Cox Proportional Hazards models. Net reclassification indices (NRI) and C statistics were calculated to evaluate their predictive performance. Results Hematuria was observed in 1145 (29%) of a total of 3272 participants at baseline. Individuals with hematuria were more likely to be Hispanic (22% vs. 9.5%, respectively), have diabetes (56% vs. 48%), lower mean eGFR (40.2 vs. 45.3 ml/min/1.73 m2), and higher levels of urinary albumin > 1.0 g/day (36% vs. 10%). In multivariable-adjusted analysis, individuals with hematuria had a greater risk for all outcomes during the first 2 years of follow-up: Halving of eGFR or ESRD (HR Year 1: 1.68, Year 2: 1.36), ESRD (Year 1: 1.71, Year 2: 1.39) and death (Year 1:1.92, Year 2: 1.77), and these associations were attenuated, thereafter. Based on NRIs and C-statistics, no clear improvement in the ability to improve prediction of study outcomes was observed when hematuria was included in multivariable models. Conclusion In a large adult cohort with CKD, hematuria was associated with a significantly higher risk of CKD progression and death in the first 2 years of follow-up but did not improve risk prediction

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Hematuria as a risk factor for progression of chronic kidney disease and death: findings from the Chronic Renal Insufficiency Cohort (CRIC) Study

BACKGROUND:Hematuria is associated with chronic kidney disease (CKD), but has rarely been examined as a risk factor for CKD progression. We explored whether individuals with hematuria had worse outcomes compared to those without hematuria in the CRIC Study. METHODS:Participants were a racially and ethnically diverse group of adults (21 to 74&nbsp;years), with moderate CKD. Presence of hematuria (positive dipstick) from a single urine sample was the primary predictor. Outcomes included a 50% or greater reduction in eGFR from baseline, ESRD, and death, over a median follow-up of 7.3&nbsp;years, analyzed using Cox Proportional Hazards models. Net reclassification indices (NRI) and C statistics were calculated to evaluate their predictive performance. RESULTS:Hematuria was observed in 1145 (29%) of a total of 3272 participants at baseline. Individuals with hematuria were more likely to be Hispanic (22% vs. 9.5%, respectively), have diabetes (56% vs. 48%), lower mean eGFR (40.2 vs. 45.3&nbsp;ml/min/1.73&nbsp;m2), and higher levels of urinary albumin &gt; 1.0&nbsp;g/day (36% vs. 10%). In multivariable-adjusted analysis, individuals with hematuria had a greater risk for all outcomes during the first 2&nbsp;years of follow-up: Halving of eGFR or ESRD (HR Year 1: 1.68, Year 2: 1.36), ESRD (Year 1: 1.71, Year 2: 1.39) and death (Year 1:1.92, Year 2: 1.77), and these associations were attenuated, thereafter. Based on NRIs and C-statistics, no clear improvement in the ability to improve prediction of study outcomes was observed when hematuria was included in multivariable models. CONCLUSION:In a large adult cohort with CKD, hematuria was associated with a significantly higher risk of CKD progression and death in the first 2&nbsp;years of follow-up but did not improve risk prediction

Orlandi, Paula F

Fujii, Naohiko

Roy, Jason

Chen, Hsiang-Yu

Lee Hamm, L

Sondheimer, James H

He, Jiang

Fischer, Michael J

Rincon-Choles, Hernan

Krishnan, Geetha

Townsend, Raymond

Shafi, Tariq

Hsu, Chi-yuan

Kusek, John W

Daugirdas, John T

Feldman, Harold I

eScholarship - University of California

Paula Orlandi (3415742)

Naohiko Fujii (2219026)

Jason Roy (770743)

Hsiang-Yu Chen (2321644)

L. Lee Hamm (467381)

James Sondheimer (5448614)

Jiang He (216340)

Michael Fischer (1445311)

Hernan Rincon-Choles (5448617)

Geetha Krishnan (5448611)

Raymond Townsend (5448608)

Tariq Shafi (734394)

Chi-yuan Hsu (3279294)

John Kusek (3443129)

John Daugirdas (5448620)

Harold Feldman (2163112)

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