Abstract P348: Incidence of Chronic Kidney Disease (CKD) and Association of Major Cardiovascular Risk Factors With CKD in the Hispanic Community Health Study/Study of Latinos (HCHS/SOL)

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Background: The prevalence of major cardiovascular risk factors and chronic kidney disease (CKD) is high in U.S. Hispanics/Latinos. Hypotheses: We assessed the hypotheses that the incidence of CKD will vary by Hispanic/Latino heritage, and that cardiovascular risk factors will be associated with incident CKD among Hispanic/Latino adults. Methods: We used data from HCHS/SOL, the largest community-based cohort of 16,415 self-identified Hispanic/Latino adults from diverse backgrounds in the U.S., aged 18-74 years at visit 1 (baseline, 2008-2011), and ongoing second clinic examination (2014-2017). This preliminary analysis describes results from 7,144 adults who attended visit 1 and 2 by September 2016, and did not have CKD at baseline. Incident CKD was defined as estimated glomerular filtration rate (eGFR) <60 ml/min/1.73m 2 and eGFR decline ≥1 ml/min/year, or urine albumin-to-creatinine ratio (UACR) ≥30 mg/g. Incidence rates for CKD and incidence rate ratios (RR) for the association between cardiovascular risk factors at baseline and incident CKD were estimated using Poisson regression with robust variance while accounting for the complex sampling design of HCHS/SOL. Results: In 5.7 years mean follow-up, 430 individuals developed CKD (61.2% women). The age- and gender-adjusted incidence rate of CKD ranged from 6.0% (South Americans) to 14.9% (Puerto Ricans) per 1000 person-years (Table). Higher systolic blood pressure (RR, 95% CI, 1.02, 1.01-1.02, per one mm Hg increment), glycated hemoglobin (1.17, 1.07-1.27, per one percentage point increment), and log-UACR (3.29, 2.60-4.16, per one unit increment) were significantly associated with incident CKD. LDL and HDL cholesterol were not significantly associated with incident CKD. Conclusions: The incidence of CKD varies markedly by Hispanic/Latino heritage. Systolic blood pressure, glycated hemoglobin and albuminuria are important in the development of CKD in this population. Future work will focus on further evaluation of these differences/associations.