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252. Healthy Lifestyle and Risk of Kidney Disease Progression, Atherosclerotic Events, and Death in CKD: Findings From the Chronic Renal Insufficiency Cohort (CRIC) Study

Author

Appel, Lawrence J., Feldman, Harold I., Go, Alan S., He, Jiang, Kusek, John W., Lash, James P., Ojo, Akinlolu, Rahman, Mahboob, Townsend, Raymond R., Ricardo, Ana C., Anderson, Cheryl A., Yang, Wei, Zhang, Xiaoming, Fischer, Michael J., Dember, Laura M., Fink, Jeffrey C., Frydrych, Anne, Jensvold, Nancy G., Lustigova, Eva, Nessel, Lisa C., Porter, Anna C., Wright Nunes, Julie A., and Daviglus, Martha L.

Published
2015
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255. Self-reported Physical Activity and Cardiovascular Events in Adults With CKD: Findings From the CRIC (Chronic Renal Insufficiency Cohort) Study

Author

Bruinius, Jacob W., primary, Hannan, Mary, additional, Chen, Jinsong, additional, Brown, Julia, additional, Kansal, Mayank, additional, Meza, Natalie, additional, Saunders, Milda R., additional, He, Jiang, additional, Ricardo, Ana C., additional, Lash, James P., additional, Appel, Lawrence J., additional, Chen, Jing, additional, Cohen, Debbie L., additional, Feldman, Harold I., additional, Go, Alan S., additional, Nelson, Robert G., additional, Rahman, Mahboob, additional, Rao, Panduranga S., additional, Shah, Vallabh O., additional, and Unruh, Mark L., additional

Published
2022
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257. Aspirin for Primary and Secondary Prevention of Mortality, Cardiovascular Disease, and Kidney Failure in the Chronic Renal Insufficiency Cohort (CRIC) Study

Author

Taliercio, Jonathan J., primary, Nakhoul, Georges, additional, Mehdi, Ali, additional, Yang, Wei, additional, Sha, Daohang, additional, Schold, Jesse D., additional, Kasner, Scott, additional, Weir, Matthew, additional, Hassanein, Mohamed, additional, Navaneethan, Sankar D., additional, Krishnan, Geetha, additional, Kanthety, Radhika, additional, Go, Alan S., additional, Deo, Rajat, additional, Lora, Claudia M., additional, Jaar, Bernard G., additional, Chen, Teresa K., additional, Chen, Jing, additional, He, Jiang, additional, Rahman, Mahboob, additional, Appel, Lawrence J., additional, Cohen, Debbie L., additional, Feldman, Harold I., additional, Lash, James P., additional, Nelson, Robert G., additional, Rao, Panduranga S., additional, Shah, Vallabh O., additional, and Unruh, Mark L., additional

Published
2022
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258. Black and White Adults With CKD Hospitalized With Acute Kidney Injury: Findings From the Chronic Renal Insufficiency Cohort (CRIC) Study

Author

Muiru, Anthony N., primary, Yang, Jingrong, additional, Derebail, Vimal K., additional, Liu, Kathleen D., additional, Feldman, Harold I., additional, Srivastava, Anand, additional, Bhat, Zeenat, additional, Saraf, Santosh L., additional, Chen, Teresa K., additional, He, Jiang, additional, Estrella, Michelle M., additional, Go, Alan S., additional, Hsu, Chi-yuan, additional, Appel, Lawrence J., additional, Chen, Jing, additional, Cohen, Debbie L., additional, Lash, James P., additional, Nelson, Robert G., additional, Rahman, Mahboob, additional, Rao, Panduranga S., additional, Shah, Vallabh O., additional, and Unruh, Mark L., additional

Published
2022
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259. Heart Failure–Type Symptom Score Trajectories in CKD: Findings From the Chronic Renal Insufficiency Cohort (CRIC) Study

Author

Walther, Carl P., primary, Benoit, Julia S., additional, Bansal, Nisha, additional, Nambi, Vijay, additional, Navaneethan, Sankar D., additional, Feldman, Harold I., additional, Appel, Lawrence J., additional, Chen, Jing, additional, Cohen, Debbie L., additional, Go, Alan S., additional, Lash, James P., additional, Nelson, Robert G., additional, Rahman, Mahboob, additional, Rao, Panduranga S., additional, Shah, Vallabh O., additional, and Unruh, Mark L., additional

Published
2022
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260. Variation in Heart Failure Risk by HIV Severity and Sex in People With HIV Infection

Author

Lam, Jennifer O., primary, Leyden, Wendy A., additional, Leong, Thomas K., additional, Horberg, Michael A., additional, Reynolds, Kristi, additional, Ambrosy, Andrew P., additional, Avula, Harshith R., additional, Hechter, Rulin C., additional, Towner, William J., additional, Vupputuri, Suma, additional, Go, Alan S., additional, and Silverberg, Michael J., additional

Published
2022
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265. Prognostic Significance of Nuisance Bleeding in Anticoagulated Patients With Atrial Fibrillation

Author

O’Brien, Emily C., Holmes, DaJuanicia N., Thomas, Laine E., Fonarow, Gregg C., Allen, Larry A., Gersh, Bernard J., Kowey, Peter R., Singer, Daniel E., Ezekowitz, Michael D., Naccarelli, Gerald V., Ansell, Jack E., Chan, Paul S., Mahaffey, Kenneth W., Go, Alan S., Freeman, James V., Reiffel, James A., Peterson, Eric D., Piccini, Jonathan P., and Hylek, Elaine M.

Published
2018
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278. Treatment of Atrial Fibrillation and Concordance With the American Heart Association/American College of Cardiology/Heart Rhythm Society Guidelines: Findings From ORBIT-AF (Outcomes Registry for Better Informed Treatment of Atrial Fibrillation)

Author

Barnett, Adam S., Kim, Sunghee, Fonarow, Gregg C., Thomas, Laine E., Reiffel, James A., Allen, Larry A., Freeman, James V., Naccarelli, Gerald, Mahaffey, Kenneth W., Go, Alan S., Kowey, Peter R., Ansell, Jack E., Gersh, Bernard J., Hylek, Elaine M., Peterson, Eric D., and Piccini, Jonathan P.

Published
2017
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279. Risk for Chronic Kidney Disease Progression After Acute Kidney Injury: Findings From the Chronic Renal Insufficiency Cohort Study.

Author

Muiru, Anthony N., Hsu, Jesse Y., Zhang, Xiaoming, Appel, Lawrence J., Chen, Jing, Cohen, Debbie L., Drawz, Paul E., Freedman, Barry I., Go, Alan S., He, Jiang, Horwitz, Edward J., Hsu, Raymond K., Lash, James P., Liu, Kathleen D., McCoy, Ian E., Porter, Anna, Rao, Panduranga, Ricardo, Ana C., Rincon-Choles, Hernan, and Sondheimer, James

Subjects
CHRONIC kidney failure, ACUTE kidney failure, DISEASE risk factors, DISEASE progression, COHORT analysis
Abstract

The effect of acute kidney injury in patients with chronic kidney disease is a subject of debate. This multicenter cohort study examined 3150 patients with chronic kidney disease to determine subsequent kidney function and trajectory after hospitalizations with acute kidney injury. Visual Abstract. Risk for Chronic Kidney Disease Progression After Acute Kidney Injury: Findings From the Chronic Renal Insufficiency Cohort Study The effect of acute kidney injury in patients with chronic kidney disease is a subject of debate. This multicenter cohort study examined 3150 patients with chronic kidney disease to determine subsequent kidney function and trajectory after hospitalizations with acute kidney injury. Background: Prior studies associating acute kidney injury (AKI) with more rapid subsequent loss of kidney function had methodological limitations, including inadequate control for differences between patients who had AKI and those who did not. Objective: To determine whether AKI is independently associated with subsequent kidney function trajectory among patients with chronic kidney disease (CKD). Design: Multicenter prospective cohort study. Setting: United States. Participants: Patients with CKD (n  = 3150). Measurements: Hospitalized AKI was defined by a 50% or greater increase in inpatient serum creatinine (SCr) level from nadir to peak. Kidney function trajectory was assessed using estimated glomerular filtration rate (eGFR) based on SCr level (eGFRcr) or cystatin C level (eGFRcys) measured at annual study visits. Results: During a median follow-up of 3.9 years, 433 participants had at least 1 AKI episode. Most episodes (92%) had stage 1 or 2 severity. There were decreases in eGFRcr (−2.30 [95% CI, −3.70 to −0.86] mL/min/1.73 m 2) and eGFRcys (−3.61 [CI, −6.39 to −0.82] mL/min/1.73 m 2) after AKI. However, in fully adjusted models, the decreases were attenuated to −0.38 (CI, −1.35 to 0.59) mL/min/1.73 m 2 for eGFRcr and −0.15 (CI, −2.16 to 1.86) mL/min/1.73 m 2 for eGFRcys, and the CI bounds included the possibility of no effect. Estimates of changes in eGFR slope after AKI determined by either SCr level (0.04 [CI, −0.30 to 0.38] mL/min/1.73 m 2 per year) or cystatin C level (−0.56 [CI, −1.28 to 0.17] mL/min/1.73 m 2 per year) also had CI bounds that included the possibility of no effect. Limitations: Few cases of severe AKI, no adjudication of AKI cause, and lack of information about nephrotoxic exposures after hospital discharge. Conclusion: After pre-AKI eGFR, proteinuria, and other covariables were accounted for, the association between mild to moderate AKI and worsening subsequent kidney function in patients with CKD was small. Primary Funding Source: National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health. [ABSTRACT FROM AUTHOR]

Published
2023
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284. Targeted Minimum Loss-Based Estimation of Causal Effects in Right-Censored Survival Data with Time-Dependent Covariates: Warfarin, Stroke, and Death in Atrial Fibrillation

Author

Brooks Jordan C., van der Laan Mark J., Singer Daniel E., and Go Alan S.

Subjects
targeted minimum loss-based estimation, survival analysis, dependent right-censoring, efficient influence curve, targeted maximum likelihood estimation, Mathematics, QA1-939, Probabilities. Mathematical statistics, QA273-280
Abstract

Causal effects in right-censored survival data can be formally defined as the difference in the marginal cumulative event probabilities under particular interventions. Conventional estimators, such as the Kaplan-Meier (KM), fail to consistently estimate these marginal parameters under dependent treatment assignment or dependent censoring. Several modern estimators have been developed that reduce bias under both dependent treatment assignment and dependent censoring by incorporating information from baseline and time-dependent covariates. In the present article we describe a recently developed targeted minimum loss-based estimation (TMLE) algorithm for general longitudinal data structures and present in detail its application in right-censored survival data with time-dependent covariates. The treatment-specific marginal cumulative event probability is defined via a series of iterated conditional expectations in a time-dependent counting process framework. The TMLE involves an initial estimator of each conditional expectation and sequentially updates these such that the resulting estimator solves the efficient influence curve estimating equation in the nonparametric statistical model. We describe the assumptions required for consistent estimation of statistical parameters and additional assumptions required for consistent estimation of the causal effect parameter. Using simulated right-censored survival data, the mean squared error, bias, and 95% confidence interval coverage probability of the TMLE is compared with those of the conventional KM and the inverse probability of censoring weight estimating equation, conventional maximum likelihood substitution estimator, and the double robustaugmented inverse probability of censoring weighted estimating equation. We conclude the article with estimation of the causal effect of warfarin medical therapy on the probability of “stroke or death” within a 1-year time frame using data from the ATRIA-1 observational cohort of persons with atrial fibrillation. Our results suggest that a fixed policy of warfarin treatment for all patients would result in 2% fewer deaths or strokes within 1-year as compared with a policy of withholding warfarin from all patients.

Published
2013
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286. Candidate Gene Association Study of Coronary Artery Calcification in Chronic Kidney Disease: Findings From the CRIC Study (Chronic Renal Insufficiency Cohort)

Author

Ferguson, Jane F., Matthews, Gregory J., Townsend, Raymond R., Raj, Dominic S., Kanetsky, Peter A., Budoff, Matthew, Fischer, Michael J., Rosas, Sylvia E., Kanthety, Radhika, Rahman, Mahboob, Master, Stephen R., Qasim, Atif, Li, Mingyao, Mehta, Nehal N., Shen, Haiqing, Mitchell, Braxton D., O'Connell, Jeffrey R., Shuldiner, Alan R., Ho, Weang Kee, Young, Robin, Rasheed, Asif, Danesh, John, He, Jiang, Kusek, John W., Ojo, Akinlolu O., Flack, John, Go, Alan S., Gadegbeku, Crystal A., Wright, Jackson T., Jr., Saleheen, Danish, Feldman, Harold I., Rader, Daniel J., Foulkes, Andrea S., and Reilly, Muredach P.

Published
2013
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290. Considerations in Controlling for Urine Concentration for Biomarkers of Kidney Disease Progression After Acute Kidney Injury.

Author

Wen, Yumeng, Wen, Yumeng, Thiessen-Philbrook, Heather, Moledina, Dennis G, Kaufman, James S, Reeves, W Brian, Ghahramani, Nasrollah, Ikizler, T Alp, Go, Alan S, Liu, Kathleen D, Siew, Eddie D, Himmelfarb, Jonathan, Kimmel, Paul L, Hsu, Chi-Yuan, Parikh, Chirag R, Wen, Yumeng, Wen, Yumeng, Thiessen-Philbrook, Heather, Moledina, Dennis G, Kaufman, James S, Reeves, W Brian, Ghahramani, Nasrollah, Ikizler, T Alp, Go, Alan S, Liu, Kathleen D, Siew, Eddie D, Himmelfarb, Jonathan, Kimmel, Paul L, Hsu, Chi-Yuan, and Parikh, Chirag R

Abstract

IntroductionBiomarkers of acute kidney injury (AKI) are often indexed to urine creatinine (UCr) or urine osmolarity (UOsm) to control for urine concentration. We evaluated how these approaches affect the biomarker-outcome association in patients with AKI.MethodsThe Assessment, Serial Evaluation, and Subsequent Sequelae in Acute Kidney Injury Study was a cohort of hospitalized patients with and without AKI between 2009 and 2015. Using Cox proportional hazards regression, we assessed the associations and predictions (C-statistics) of urine biomarkers with a composite outcome of incident chronic kidney disease (CKD) and CKD progression. We used 4 approaches to account for urine concentration: indexing and adjusting for UCr and UOsm.ResultsAmong 1538 participants, 769 (50%) had AKI and 300 (19.5%) developed composite CKD outcome at median follow-up of 4.7 years. UCr and UOsm during hospitalization were inversely associated with the composite CKD outcome. The associations and predictions with CKD were significantly strengthened after indexing or adjusting for UCr or UOsm for urine kidney injury molecule-1 (KIM-1), interleukin-18 (IL-18), and monocyte chemoattractant protein-1 (MCP-1) in patients with AKI. There was no significant improvement with indexing or adjusting UCr or UOsm for albumin, neutrophil gelatinase-associated lipocalin (NGAL), and chitinase 3-like 1 (YKL-40). Uromodulin's (UMOD) inverse association with the outcome was significantly blunted after indexing but not adjusting for UCr or UOsm.ConclusionUCr and UOsm during hospitalization are inversely associated with development and progression of CKD. Indexing or adjusting for UCr or UOsm strengthened associations and improved predictions for CKD for only some biomarkers. Incorporating urinary concentration should be individualized for each biomarker in research and clinical applications.

Published
2022

291. Absence of long-term changes in urine biomarkers after AKI: findings from the CRIC study.

Author

McCoy, Ian E, McCoy, Ian E, Hsu, Jesse Y, Bonventre, Joseph V, Parikh, Chirag R, Go, Alan S, Liu, Kathleen D, Ricardo, Ana C, Srivastava, Anand, Cohen, Debbie L, He, Jiang, Chen, Jing, Rao, Panduranga S, Muiru, Anthony N, Hsu, Chi-Yuan, McCoy, Ian E, McCoy, Ian E, Hsu, Jesse Y, Bonventre, Joseph V, Parikh, Chirag R, Go, Alan S, Liu, Kathleen D, Ricardo, Ana C, Srivastava, Anand, Cohen, Debbie L, He, Jiang, Chen, Jing, Rao, Panduranga S, Muiru, Anthony N, and Hsu, Chi-Yuan

Abstract

BackgroundMechanisms by which AKI leads to CKD progression remain unclear. Several urine biomarkers have been identified as independent predictors of progressive CKD. It is unknown whether AKI may result in long-term changes in these urine biomarkers, which may mediate the effect of AKI on CKD progression.MethodsWe selected 198 episodes of hospitalized AKI (defined as peak/nadir inpatient serum creatinine values ≥ 1.5) among adult participants in the Chronic Renal Insufficiency Cohort (CRIC) Study. We matched the best non-AKI hospitalization (unique patients) for each AKI hospitalization using pre-hospitalization characteristics including eGFR and urine protein/creatinine ratio. Biomarkers were measured in banked urine samples collected at annual CRIC study visits.ResultsUrine biomarker measurements occurred a median of 7 months before and 5 months after hospitalization. There were no significant differences in the change in urine biomarker-to-creatinine ratio between the AKI and non-AKI groups: KIM-1/Cr + 9% vs + 7%, MCP-1/Cr + 4% vs + 1%, YKL-40/Cr + 7% vs -20%, EGF/Cr -11% vs -8%, UMOD/Cr -2% vs -7% and albumin/Cr + 17% vs + 13% (all p > 0.05).ConclusionIn this cohort of adults with CKD, AKI did not associate with long-term changes in urine biomarkers.

Published
2022

298. Research Needs to Improve Hypertension Treatment and Control in African Americans

Author

Whelton, Paul K., Einhorn, Paula T., Muntner, Paul, Appel, Lawrence J., Cushman, William C., Diez Roux, Ana V., Ferdinand, Keith C., Rahman, Mahboob, Taylor, Herman A., Ard, Jamy, Arnett, Donna K., Carter, Barry L., Davis, Barry R., Freedman, Barry I., Cooper, Lisa A., Cooper, Richard, Desvigne-Nickens, Patrice, Gavini, Nara, Go, Alan S., Hyman, David J., Kimmel, Paul L., Margolis, Karen L., Miller, Edgar R., III, Mills, Katherine T., Mensah, George A., Navar, Ann M., Ogedegbe, Gbenga, Rakotz, Michael K., Thomas, George, Tobin, Jonathan N., Wright, Jackson T., Yoon, Sung Sug (Sarah), and Cutler, Jeffrey A.

Published
2016
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299. Research Opportunities in Stroke Prevention for Atrial Fibrillation: A Report From a National Heart, Lung, and Blood Institute Virtual Workshop.

Author

Go, Alan S., Al-Khatib, Sana M., Desvigne-Nickens, Patrice, Bansal, Nisha, Bushnell, Cheryl D., Fang, Margaret C., Freeman, James V., Gage, Brian F., Hanke, Thorsten, Hylek, Elaine M., Lopes, Renato D., Noseworthy, Peter A., Reddy, Vivek Y., Singer, Daniel E., Thomas, Kevin L., True Hills, Mellanie, Turakhia, Mintu P., Zieman, Susan J., Cooper, Lawton S., and Benjamin, Emelia J.

Published
2023
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300. Breast arterial calcification is associated with incident atrial fibrillation among older but not younger post-menopausal women.

Author

Iribarren, Carlos, Chandra, Malini, Parikh, Rishi V, Sanchez, Gabriela, Sam, Danny L, Azamian, Farima Faith, Cho, Hyo-Min, Ding, Huanjun, Molloi, Sabee, and Go, Alan S

Subjects
CALCIFICATIONS of the breast, ARTERIAL calcification, ATRIAL fibrillation, POSTMENOPAUSE, YOUNG women, ATRIAL flutter
Abstract

Aims The goal of this study was to examine the association of breast arterial calcification (BAC) presence and quantity with incident atrial fibrillation (AF) in a large cohort of post-menopausal women. Methods and results We conducted a longitudinal cohort study among women free of clinically overt cardiovascular disease and AF at baseline (between October 2012 and February 2015) when they attended mammography screening. Atrial fibrillation incidence was ascertained using diagnostic codes and natural language processing. Among 4908 women, 354 incident cases of AF (7%) were ascertained after a mean (standard deviation) of 7 (2) years of follow-up. In Cox regression adjusting for a propensity score for BAC, BAC presence vs. absence was not significantly associated with AF [hazard ratio (HR) = 1.12; 95% confidence interval (CI), 0.89–1.42; P = 0.34]. However, a significant (a priori hypothesized) age by BAC interaction was found (P = 0.02) such that BAC presence was not associated with incident AF in women aged 60–69 years (HR = 0.83; 95% CI, 0.63–1.15; P = 0.26) but was significantly associated with incident AF in women aged 70–79 years (HR = 1.75; 95% CI, 1.21–2.53; P = 0.003). No evidence of dose–response relationship between BAC gradation and AF was noted in the entire cohort or in age groups separately. Conclusion Our results demonstrate, for the first time, an independent association between BAC and AF in women over age 70 years. [ABSTRACT FROM AUTHOR]

Published
2023
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