Black adults who develop CKD young may be at higher risk for eGFR decline vs. white adults
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Key takeaways:
- The rate of eGFR decline accelerated as the age of CKD onset decreased in Black veterans.
- Younger Black patients who developed CKD had a faster eGFR decline than older Black patients.
SAN DIEGO — Black veterans who develop chronic kidney disease at a young age may be at a higher risk for eGFR decline than white veterans, according to data presented at Kidney Week.
“Recent research reveals when CKD onset was determined using the new race-free CKD-EPI creatinine equation, Black adults still had a twofold higher risk for subsequent progression to kidney failure compared to their white counterparts,” Guofen Yan, PhD, a biostatistitian at University of Virginia, Charlottesville, said during a presentation. The research aimed to “evaluate how the two race groups differ in eGFR decline after CKD onset, particularly whether age modifies the group difference in eGFR decline.”
Researchers studied 54,728 non-Hispanic Black adults and 256,479 non-Hispanic white adults in the U.S. Veterans Health Administration, aged 18 to 85 years, with new onset of CKD between 2005 and 2012. Patients had quarterly eGFR measurements for up to 6 years.
Researchers calculated eGFR from outpatient serum creatinine levels based on the 2021 CKD-EPI creatinine equation, and defined CKD onset by the first occurrence of two eGFR values of less than 60 mL/min/1.73 m2 measured at more than 3 months apart.
The groups had similar mean eGFRs of 51 mL/min/1.73 m2 at the onset of CKD, although Black patients were 8 years younger than white patients (mean age 65 years compared with 73 years).
Researchers found the rate of eGFR decline accelerated as the age of CKD onset decreased in Black patients. Younger Black patients who developed CKD had a faster eGFR decline than older Black patients, whereas the opposite was seen for white patients.
“The disparities were in the younger ages, with a greater rate of decline in younger Black patients than in younger white patients,” Yan said.
Racial differences in kidney decline were larger in veterans who developed CKD younger, data showed, which could be explained by rapid decline in a subset of young Black veterans.
Further research may help delineate different mechanisms for care, according to Yan. “Identifying genetic, biological and social factors underlying the younger onset of CKD for Black adults and their subsequent fast progression is urgently needed,” she said.
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Yan G, et al. TH-OR02. Presented at: ASN Kidney Week; Oct. 24-27, 2024; San Diego.
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