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Chronic Renal Insufficiency Cohort (CRIC) Study: Baseline Characteristics and Associations with Kidney Function
Open accessAbstract
BACKGROUND AND OBJECTIVES: The Chronic Renal Insufficiency Cohort (CRIC) Study was established to examine risk factors for the progression of chronic kidney disease (CKD) and cardiovascular disease (CVD) in patients with CKD. We examined baseline demographic and clinical characteristics. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: Seven clinical centers recruited adults who were aged 21 to 74 yr and had CKD using age-based estimated GFR (eGFR) inclusion criteria. At baseline, blood and urine specimens were collected and information regarding health behaviors, diet, quality of life, and functional status was obtained. GFR was measured using radiolabeled iothalamate in one third of participants. RESULTS: A total of 3612 participants were enrolled with mean age +/- SD of 58.2 +/- 11.0 yr; 46% were women, and 47% had diabetes. Overall, 45% were non-Hispanic white, 46% were non-Hispanic black, and 5% were Hispanic. Eighty-six percent reported hypertension, 22% coronary disease, and 10% heart failure. Mean body mass index was 32.1 +/- 7.9 kg/m(2), and 47% had a BP >130/80 mmHg. Mean eGFR was 43.4 +/- 13.5 ml/min per 1.73 m(2), and median (interquartile range) protein excretion was 0.17 g/24 h (0.07 to 0.81 g/24 h). Lower eGFR was associated with older age, lower socioeconomic and educational level, cigarette smoking, self-reported CVD, peripheral arterial disease, and elevated BP. CONCLUSIONS: Lower level of eGFR was associated with a greater burden of CVD as well as lower socioeconomic and educational status. Long-term follow-up of participants will provide critical insights into the epidemiology of CKD and its relationship to adverse outcomes.
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“Difficulty controlling BP in late stages of CKD was also seen in CRIC (Chronic Renal Insufficiency Cohort), in which 88% of participants had stage 3 or 4 CKD.”
From Resistant Hypertension: Detection, Evaluation, and Management: A Scientific Statement From the American Heart Association (2018) · cites this paper as [302]
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“Age (yr), mean6SD 3164 2864 4163 4163 5163 5063 6063 6163 7063 7063 Male, n (%) 95 (52) 1933 (43) 195 (61) 1357 (50) 380 (55) 1183 (51) 793 (56) 970 (49) 472 (55) 858 (51) Race/ethnicity, n (%) Black 70 (38) 868 (19) 129 (40) 571 (21) 338 (48) 472 (20) 649 (46) 336 (17) 372 (43) 269 (16) Hispanic 36 (20) 1438 (32) 53…”
Mahmood, U., Healy, H. G., Kark, A., Cameron, A. L., Wang, Z., Abeysekera, R. A., & Hoy, W. E. (2017) · BMC Nephrology · doi:10.1186/s12882-017-0781-5 · Cited by 20
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“The study design and baseline participant characteristics have been previously described.(18,19) In brief, participants were eligible for enrollment if they were aged 21-44 years with an eGFR of 20-70 mL/min/ 1.”
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Self-citationClinical Factors Associated With the Diagnosis and Progression of Diabetic Nephropathy
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“In a group of patients with CKD enrolled in the Chronic Renal Insufficiency Cohort (CRIC) study [48], retinopathy was present in 456 (49 %) of 925 participants with diabetes and in 115 (11 %) of 1,011 participants without diabetes.”
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Self-citationGlobal Burden of Diabetes Mellitus
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“6) Systolic BP, mmHg 128 (22) 128 (22) 131 (21) Diastolic BP, mmHg 72 (13) 72 (13) 69 (13) Heart rate, bpm 65 (12) 65 (12) 65 (11) eGFR by CKD-EPI, ml/min per 1.”
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“The design and baseline characteristics of the CRIC Study have been previously published.(24,25) During the first phase of recruitment, between 2003 and 2007, a total of 3,612 participants were enrolled into the study.”
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“There is a void of literature on the long-term effects of sodium in an extensively studied CKD population, and therefore, we sought to evaluate the effect of dysnatremias on mortality and kidney failure from patients enrolled in the Chronic Renal Insufficiency Cohort (CRIC) study.(19)”
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Self-citationAdvances in management of chronic metabolic acidosis in chronic kidney disease
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Inhibition of CYP1B1 ameliorates cardiac hypertrophy induced by uremic toxin
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Self-citationAssociation between iron status markers and kidney outcome in patients with chronic kidney disease
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“In the CRIC Study, most participants were non-Hispanic white patients or non-Hispanic Black/African-American patients 45 .”
BackgroundGenetic African Ancestry and Markers of Mineral Metabolism in CKD
Gutiérrez, O. M., Parsa, A., Isakova, T., Scialla, J. J., Chen, J., Flack, J. M., Nessel, L. C., Gupta, J., Bellovich, K. A., Steigerwalt, S. P., et al. (2016) · Clinical Journal of the American Society of Nephrology · doi:10.2215/cjn.08020715 · Cited by 18
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Self-citationArterial Stiffness, Kidney Function, and Chronic Kidney Disease Progression
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“The design of the CRIC Study is described in detail elsewhere [15, 16].”
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“The Chronic Renal Insufficiency Cohort (CRIC) Study [65] showed an association between the degree of loss of renal function and abnormalities in cardiac structure, mainly higher left ventricular mass, but polycystic kidney disease had been excluded from the trial.”
BackgroundRuszkowski, J., Majkutewicz, K., Heleniak, Z., Witkowski, J. M., & Dębska-Ślizień, A. M. (2022) · Journal of Clinical Medicine · doi:10.3390/jcm11216363 · Cited by 17
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“Weight (kg) and height (m) were measured using standard protocols (9) and used to calculate BMI as kg/m2.”
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“Details regarding the design, methods, and baseline characteristics of the cohort have been previously described [9–11].”
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Self-citationPrognostic values of left ventricular mass index in chronic kidney disease patients
Tripepi, G. L., D’Arrigo, G., Mallamaci, F., London, G. M., Tangri, N., Hsu, J. Y., Feldman, H. I., & Zoccali, C. (2019) · Nephrology Dialysis Transplantation · doi:10.1093/ndt/gfz254 · Cited by 16
Self-citationTummalapalli, S. L., Zelnick, L. R., Andersen, A. H., Christenson, R. H., deFilippi, C. R., Deo, R., Go, A. S., He, J., Ky, B., Lash, J. P., et al. (2020) · Journal of the American Heart Association · doi:10.1161/jaha.119.014385 · Cited by 17
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“These include well-known worldwide studies such as the Chronic Renal Insuf fi ciency Cohort (CRIC) [43], Chronic Kidney Disease in Children (CKid) [44], Canadian study of prediction of death, dialysis and interim cardiovascular events (CaNPREDDICT) [45], NEFRONA [46], the French CKD renal epidemiology and information N…”
BackgroundEpidemiology of Acid-Base Derangements in CKD
Chen, W., & Abramowitz, M. K. (2017) · Advances in Chronic Kidney Disease · doi:10.1053/j.ackd.2017.08.003 · Cited by 16
Kitamura, H., Tanaka, S., Hiyamuta, H., Shimamoto, S., Tsuruya, K., Nakano, T., & Kitazono, T. (2022) · Journal of Atherosclerosis and Thrombosis · doi:10.5551/jat.63891 · Cited by 15
Ramos, M., Gerlier, L. C., Uster, A., Muttram, L., Frankel, A., & Lamotte, M. (2024) · Journal of Medical Economics · doi:10.1080/13696998.2024.2357041 · Cited by 15
“Baseline characteristics and clinical risk factors for the study population were sourced from the EMPA-KIDNEY trial, and, where necessary, from the relevant published literature (Supplementary Table S1) 11–13 .”
Schrauben, S. J., Zhang, X., Xie, D., Coca, S. G., Greenberg, J. H., Ix, J. H., Shlipak, M. G., Hsu, C., Taliercio, J. J., Parikh, C. R., et al. (2025) · Clinical Journal of the American Society of Nephrology · doi:10.2215/cjn.0000000711 · Cited by 16
Self-citationVenuthurupalli, S. K., Healy, H. G., Fassett, R. G., Cameron, A. L., Wang, Z., & Hoy, W. E. (2019) · Nephrology · doi:10.1111/nep.13567 · Cited by 15
Madrigal, J. M., Cedillo-Couvert, E. A., Ricardo, A. C., Appel, L. J., Anderson, C. A. M., Deo, R., Hamm, L. L., Cornish-Zirker, D., Tan, T. C., Sha, D., et al. (2020) · Journal of the Academy of Nutrition and Dietetics · doi:10.1016/j.jand.2019.12.013 · Cited by 15
Self-citationHospitalization Trajectories and Risks of ESKD and Death in Individuals With CKD
Srivastava, A., Cai, X., Mehta, R. C., Lee, J. J., Chu, D. I., Mills, K. T., Shafi, T., Taliercio, J. J., Hsu, J. Y., Schrauben, S. J., et al. (2021) · Kidney International Reports · doi:10.1016/j.ekir.2021.03.883 · Cited by 21
Self-citationAssociation of Proximal Tubular Secretory Clearance with Long-Term Decline in Cognitive Function
Lidgard, B., Bansal, N., Zelnick, L. R., Hoofnagle, A., Chen, J., Colaizzo, D., Dobre, M. A., Mills, K. T., Porter, A. C., Rosas, S. E., et al. (2022) · Journal of the American Society of Nephrology · doi:10.1681/asn.2021111435 · Cited by 15
Chronic Kidney Disease: A Life Course Health Development Perspective
Brophy, P. D., Charlton, J. R., Carmody, J. B., Reidy, K. J., Harshman, L. A., Segar, J. L., Askenazi, D. J., Shoham, D. A., & Bagby, S. P. (2017) · Springer eBooks · doi:10.1007/978-3-319-47143-3_16 · Cited by 15
Starting Renal Replacement Therapy: Is It About Time?
Ku, E., McCulloch, C. E., & Johansen, K. L. (2019) · American Journal of Nephrology · doi:10.1159/000501510 · Cited by 16
Nishiwaki, H., Missikpode, C., Ricardo, A. C., Yang, W., Anderson, A. H., Lash, J. P., Kelly, T. N., Appel, L. J., Chen, J., Cohen, D. L., et al. (2025) · American Journal of Kidney Diseases · doi:10.1053/j.ajkd.2025.01.010 · Cited by 14
Self-citationBuilding a network of ADPKD reference centres across Europe: the EuroCYST initiative
Petzold, K., Gansevoort, R. T., Ong, A. C. M., Devuyst, O., Girardat-Rotar, L., Eckardt, K., Köttgen, A., Pirson, Y., Remuzzi, G., Sandford, R. N., et al. (2014) · Nephrology Dialysis Transplantation · doi:10.1093/ndt/gfu091 · Cited by 14
“conclusions to be drawn using a smaller sample size [23–25].”
BackgroundOh, K., Park, S. K., Kim, J., Ahn, C., & Representing the KNOW-CKD Study Investigators (2022) · Journal of Preventive Medicine and Public Health · doi:10.3961/jpmph.22.031 · Cited by 14
“It is exceptional that, unlike other CKD cohort studies such as the Chronic Renal Insufficiency Cohort (CRIC) of the United States [9,10] or the Chronic Kidney Disease Japan Cohort (CKD-JAC) of Japan [11], the KNOW-CKD study also recruited subjects at early stages of CKD (stage G1 and G2), as well as advanced stages,…”
ResultImportance of Metabolic Acidosis as a Health Risk in Chronic Kidney Disease
Vincent-Johnson, A., & Scialla, J. J. (2022) · Advances in Chronic Kidney Disease · doi:10.1053/j.ackd.2022.05.002 · Cited by 14
Taliercio, J. J., Nakhoul, G., Mehdi, A., Yang, W., Sha, D., Schold, J. D., Kasner, S. E., Weir, M., Hassanein, M., Navaneethan, S. D., et al. (2022) · Kidney Medicine · doi:10.1016/j.xkme.2022.100547 · Cited by 14
Self-citationTsopgni, W. D. T., Azébazé, A. G. B., Teinkela, J. E. M., Ndjakou, B. L., Bosyom, F. F., Tchaleu, B. N., & Vardamides, J. C. (2019) · Biochemical Systematics and Ecology · doi:10.1016/j.bse.2019.103913 · Cited by 14
Hamano, T., Fujii, N., Matsui, I., Nakano, C., Inoue, K., Tomida, K., Mikami, S., Okada, N., Tsubakihara, Y., Rakugi, H., et al. (2011) · Therapeutic Apheresis and Dialysis · doi:10.1111/j.1744-9987.2011.00918.x · Cited by 14
“vitamin D is not added to milk, orange juice or cereal, unlike in the USA); (ii) higher urinary protein excretion in Japanese CKD patients than in American CKD patients as shown in CKD– JAC (Japanese cohort) (16) and CRIC (Chronic Renal Insufficiency Cohort) studies (17); and (iii) the inability of Japanese physicians…”
BackgroundZhang, X., McCulloch, C. E., Lin, F., Lin, Y., Allen, I. E., Bansal, N., Go, A. S., & Hsu, C. (2016) · Clinical Journal of the American Society of Nephrology · doi:10.2215/cjn.12821215 · Cited by 14
Self-citationSantoro, A., Gibertoni, D., Rucci, P., Mancini, E., Bonucchi, D., Buscaroli, A., Campagna, A., Cappelli, G., David, S., Gregorini, M. C., et al. (2019) · Journal of Nephrology · doi:10.1007/s40620-018-00570-2 · Cited by 14
Muiru, A. N., Yang, J., Derebail, V. K., Liu, K. D., Feldman, H. I., Srivastava, A., Bhat, Z. Y., Saraf, S. L., Chen, T. K., He, J., et al. (2022) · American Journal of Kidney Diseases · doi:10.1053/j.ajkd.2022.02.021 · Cited by 13
Self-citationSatoh, H., Ohira, T., Nagai, M., Hosoya, M., Sakai, A., Watanabe, T., Ohtsuru, A., Kawasaki, Y., Suzuki, H., Takahashi, A., et al. (2016) · Internal Medicine · doi:10.2169/internalmedicine.55.7023 · Cited by 13
“73 m(2) and the risk of overall mortality, cardiovascular mortality, CKD progression, ESKD, and acute renal failure (8-12).”
BackgroundNIDDK initiatives addressing health disparities in chronic diseases
Roberts, B. T., & Rodgers, G. P. (2020) · Journal of Clinical Investigation · doi:10.1172/jci141563 · Cited by 13
“NMRI, though supported by the NIDDK, progression of chronic kidney disease (CKD) and cardiovascular disease in people with CKD (5).”
BackgroundGaweda, A. E., McBride, D. E., Lederer, E. D., & Brier, M. E. (2021) · American Journal of Physiology-Renal Physiology · doi:10.1152/ajprenal.00159.2020 · Cited by 13
Estrella, M. L., Allen‐Meares, P., Ricardo, A. C., Fischer, M. J., Gordon, E. J., Carmona-Powell, E., Sondheimer, J., Chen, J., Horwitz, E. J., Wang, X., et al. (2022) · Nephrology Dialysis Transplantation · doi:10.1093/ndt/gfac201 · Cited by 13
Self-citationIncreasing Use of Vitamin D Supplementation in the Chronic Renal Insufficiency Cohort Study
Mariani, L. H., White, M. T., Justine Shults, A., Anderson, C. A. M., Feldman, H. I., Wolf, M., Reese, P. P., Denburg, M., Townsend, R. R., Lo, J. C.-M., et al. (2014) · Journal of Renal Nutrition · doi:10.1053/j.jrn.2014.01.015 · Cited by 13
Self-citationZhou, Y., Zhang, J., Zhang, W., & Ni, Z. (2016) · Journal of Research in Medical Sciences · doi:10.4103/1735-1995.184000 · Cited by 13
“[18,19] The Chronic Renal Insufficiency Cohort Study data showed PAD in 7% of adult chronic kidney disease patients.[20] In HD patients, the incident of PAD is higher than that of the general population.”
BackgroundZhou, C., Wang, F., Wang, J., Zhang, L., & Zhao, M. (2016) · Chinese Medical Journal · doi:10.4103/0366-6999.190678 · Cited by 13
“Our study revealed that Chinese CKD patients had a serum phosphorus level comparable to that from the US,[14,15] Italy,[16] and Japan.”
ResultAPOL1, Acid Load, and CKD Progression
Pike, M., Stewart, T. G., Morse, J. L., Ormsby, P., Siew, E. D., Hung, A. M., Abdel-Kader, K. F. M., Ikizler, T. A., Lipworth, L. P., & Robinson‐Cohen, C. (2019) · Kidney International Reports · doi:10.1016/j.ekir.2019.03.022 · Cited by 13
“In a study of 15,055 participants in the Atherosclerosis Risk in Communities Study, Rebholz et al.10 found that a higher dietary acid load (PRAL and NEAP) was associated with a higher risk of incident CKD. Similarly, among individuals with CKD in the National Health and Nutrition Examination Survey III, a higher dieta…”
InfluentialJanus, S. E., Hajjari, J., & Al-Kindi, S. G. (2019) · Heart Rhythm · doi:10.1016/j.hrthm.2019.08.015 · Cited by 13
“The estimated glomerular filtration rate (GFR) to define eligibility was based on the simplified MDRD estimating equation (12).”
MethodWang, K., Zelnick, L. R., Chertow, G. M., Himmelfarb, J., & Bansal, N. (2021) · Kidney Medicine · doi:10.1016/j.xkme.2020.12.008 · Cited by 14
“This is an ancillary study of CRIC, a multicenter prospective study of adults with mild to moderate CKD that enrolled 3,939 participants between June 2003 and August 2008 at 7 clinical centers across the United States.25,26 The CRIC Study enrolled participants with Modification of Diet in Renal Disease (MDRD) Study eq…”
MethodInfluentialPatient Experience with Primary Care Physician and Risk for Hospitalization in Hispanics with CKD
Cedillo-Couvert, E. A., Hsu, J. Y., Ricardo, A. C., Fischer, M. J., Gerber, B. S., Horwitz, E. J., Kusek, J. W., Lustigova, E., Renteria, A., Rosas, S. E., et al. (2018) · Clinical Journal of the American Society of Nephrology · doi:10.2215/cjn.03170318 · Cited by 13
Self-citationLiu, L. (2015) · International Cardiovascular Forum Journal · doi:10.17987/icfj.v2i1.70 · Cited by 12
Hallan, S. I., Øvrehus, M. A., Darshi, M., Montemayor, D., Langlo, K. A. R., Bruheim, P., Sharma, K., & the CRIC Study Investigators (2023) · Kidney360 · doi:10.34067/kid.0000000000000248 · Cited by 13
Grunwald, J. E., Pistilli, M., Ying, G., Maguire, M. G., Daniel, E., Martin, R., Ostroff, C. P., Jacoby, D. S., Go, A. S., Townsend, R. R., et al. (2020) · British Journal of Ophthalmology · doi:10.1136/bjophthalmol-2019-315333 · Cited by 12
Self-citationLidgard, B., Zelnick, L. R., Go, A., O'Brien, K., Bansal, N., Appel, L., Chen, J., Cohen, D. L., Feldman, H., Lash, J., et al. (2022) · Journal of the American Heart Association : Cardiovascular and Cerebrovascular Disease · doi:10.1161/jaha.121.024913 · Cited by 9
Self-citationTestican-2 Is Associated with Reduced Risk of Incident ESKD
Wen, D., Zhou, L., Zheng, Z., Surapaneni, A., Ballantyne, C. M., Hoogeveen, R. C., Shlipak, M. G., Waikar, S. S., Vasan, R. S., Kimmel, P. L., et al. (2022) · Journal of the American Society of Nephrology · doi:10.1681/asn.2022020216 · Cited by 12
Self-citationMehta, R. C., Ying, G. S., Houston, S. K. S., Isakova, T., Nessel, L. C., OJO, A. O., Go, A. S., Lash, J., Kusek, J. W., Grunwald, J. E., et al. (2015) · Nephrology Dialysis Transplantation · doi:10.1093/ndt/gfv123 · Cited by 12
Self-citationMaternal determinants of renal mass and function in the fetus and neonate
Brophy, P. D. (2017) · Seminars in Fetal and Neonatal Medicine · doi:10.1016/j.siny.2017.01.004 · Cited by 12
Hui, R. (2020) · Advances in experimental medicine and biology · doi:10.1007/978-981-15-2517-9_6 · Cited by 13
Kula, A. J., Katz, R., Zelnick, L. R., Soliman, E. Z., Go, A. S., Shlipak, M. G., Deo, R., Ky, B., DeBoer, I., Anderson, A. H., et al. (2020) · Nephrology Dialysis Transplantation · doi:10.1093/ndt/gfaa296 · Cited by 12
“Additional details on study design, inclusion and exclusion criteria and baseline characteristics of the participants have been previously published [24, 25].”
BackgroundSelf-citation
Metadata
- Authors
- Lash, J. P., Go, A. S., Appel, L. J., He, J., Ojo, A., Rahman, M., Townsend, R. R., Xie, D., Cifelli, D., Cohan, J., Fink, J. C., Fischer, M. J., Gadegbeku, C., Hamm, L. L., Kusek, J. W., Landis, J. R., Narva, A., Robinson, N., Teal, V., & Feldman, H. I.
- Affiliations
- University of Illinois Chicago (US)
- Kaiser Permanente (US)
- Johns Hopkins University (US)
- Tulane University (US)
- University of Michigan (US)
- University of Maryland, Baltimore (US)
- Edward Hines, Jr. VA Hospital (US)
- National Institutes of Health (US)
- Corresponding author
- Lash, James P.
- Rahman, Mahboob
- Cohan, Janet
- Fischer, Michael J.
- Kusek, John W.
- Narva, Andrew
- ORCID
- Venue
- Clinical Journal of the American Society of Nephrology
- Published
- 2009-08
- Volume
- 4
- Issue
- 8
- Pages
- 1302-1311
- ISSN
- 1555-9041 (ISSN-L)
- PMC
- PMC2723966
- OpenAlex
- W2160134719
- Cited by
- 619
- References
- 52
- Citations by year
- 2026: 37 · 2025: 36 · 2024: 42 · 2023: 40 · 2022: 58 · 2021: 52 · 2020: 51 · 2019: 39 · 2018: 34 · 2017: 32 · 2016: 48 · 2015: 34 · 2014: 27 · 2013: 37 · 2012: 23
- FWCI
- 11.94
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Clinical Journal of the American Society of Nephrology (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Institutes of Health (5k24dk002651-10)
- University of Illinois at Urbana-Champaign
- National Institute of Diabetes and Digestive and Kidney Diseases (5U01DK06102, 5K24DK002651, R01DK072231, K24-DK002651, U01DK060990, 5U01 DK60980, T32DK060455, U01DK060984, U01DK060902, U01DK060980, U01DK060963, U01DK061021, U01DK061028)
- National Center for Research Resources (UL1RR024131, RR-05096, UL1RR024989, UL1RR025005, M01RR013987, M01RR016500, M01RR-013987-06, UL1RR024986, M01RR005096, M01 RR-024986, M01RR 16500, M01RR000042)
- Topics
- Health Sciences › Medicine › Nephrology › Chronic Kidney Disease and Diabetes
- Health Sciences › Medicine › Nephrology › Dialysis and Renal Disease Management
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Blood Pressure and Hypertension Studies
- Keywords
- chronic kidney disease, estimated glomerular filtration rate, cardiovascular disease, chronic kidney disease progression, risk factors, socioeconomic status, educational attainment, hypertension, diabetes mellitus, proteinuria, peripheral arterial disease, smoking, quality of life, functional status, CRIC study
- MeSH terms
- Adult, Age Factors, Aged, Blood Pressure, Cardiovascular Diseases, Educational Status, Female, Glomerular Filtration Rate, Humans, Kidney, Kidney Failure, Chronic, Male, Middle Aged, Prospective Studies, Proteinuria, Risk Factors, Smoking, Social Class, United States, Disease Progression, Risk Assessment, Patient Selection, Renal Insufficiency, Chronic, Young Adult
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