211 Summary Figures S4 Am J Kidney Dis. 212;59(3)(suppl 2):S4-S64
Definitions DATA ANALYSES DIABETES Self-reported diabetes, self reported diabetic retinopathy, receiving medication for diabetes, or elevated blood glucose (WHO); fasting blood sugar 126 mg/dl or nonfasting blood sugar 2 mg/dl, or A1c 7% (if available) SELF-REPORTED DIABETES Self-reported diabetes or self-reported diabetic retinopathy GLYCEMIC CONTROL Fasting blood sugar <126 mg/dl or non-fasting blood sugar <2 mg/dl, and A1c <7% (if available) HYPERTENSION Self reported history hypertension, receiving a medication for hypertension, or elevated blood pressure (JNC7): Diabetes or ; systolic 13 mmhg or diastolic 8 mmhg, otherwise systolic 14 mmhg or diastolic 9 mmhg SELF-REPORTED HYPERTENSION Self-reported hypertension BLOOD PRESSURE CONTROL Diabetes or : systolic <13 mmhg and diastolic <8 mmhg, otherwise systolic <14 mmhg and diastolic <9 mmhg HIGH CHOLESTEROL Self-reported high cholesterol or receiving medication for cholesterol, or cholesterol level >2 mg/dl SELF-REPORTED HIGH CHOLESTEROL Self-reported high cholesterol CHOLESTEROL CONTROL Total cholesterol levels of 2 mg/dl SELF-REPORTED CARDIOVASCULAR DISEASE Participant reports any of the following cardiac events: heart attack, bypass surgery, heart angioplasty, stroke, heart failure, abnormal heart rhythm, or PVD (only for version 2) MICROALBUMINURIA Albumin/creatinine ratio 3 mg/g CHRONIC KIDNEY DISEASE egfr <6 ml/min/1.73 m 2 or egfr 6 ml/min/1.73 m 2 and albumin-creatinine ratio (ACR) 3 mg/g. GFR estimated using the IDMS-traceable 4-variable Modification of Diet in Renal Disease (MDRD) Study equation or Chronic Kidney Disease Epidemiology Collaboration equation (-EPI) for calibrated serum creatinine (Scr) values STAGES Stage 1: egfr 9 ml/min/1.73 m 2, and ACR 3 mg/g Stage 2: egfr 6 89 ml/min/1.73 m 2, and ACR 3 mg/g Stage 3: egfr 3 59 ml/min/1.73 m 2 Stage 4: egfr 15 29 ml/min/1.73 m 2 Stage 5: egfr <15 ml/min/1.73 m 2 ANEMIA WHO Male: hemoglobin <13 g/dl Female: <12g/dl KDOQI (26) Males: hemoglobin <13.5 g/dl Women <12g/dl BODY MASS INDEX CATEGORIES UW: underweight, BMI <18.5 N: normal, BMI 18.5 24.9 OW: overweight, BMI 25 29.9 OB: obese, BMI 3 39.9 EOB: extremely obese, BMI 4 EDUCATIONAL STATUS GSL: Grade school or less SHS: Some high school HSG: High school graduate SC+: Some college, college graduate, post-graduate NHANES 1999 26 DATA ANALYSES SELF-REPORTED DIABETES To be classified as having self-reported diabetes, participants had to report being told by a doctor, at any time, that they had diabetes or sugar diabetes other than that related to pregnancy. Participants answering borderline to the question were classified as non-diabetic. SELF-REPORTED HYPERTENSION Self-reported hypertension was identified by an affirmative answer to the question: Have you ever been told by a doctor that you had hypertension, also called high blood pressure. SELF-REPORTED HIGH CHOLESTEROL Self-reported high cholesterol was identified by an affirmative answere to the question: Have you ever been told by a doctor or other health professional that your blood cholesterol level was high? SELF-REPORTED CARDIOVASCULAR DISEASE Participant reports any of the following cardiac events: coronary heart disease, angina/angina pectoris, heart attack, congestive heart failure, or stroke. MICROALBUMINURIA Albumin/creatinine ratio 3 mg/g CHRONIC KIDNEY DISEASE egfr <6 ml/min/1.73 m 2 or egfr 6 ml/min/1.73 m 2 and albumin-creatinine ratio (ACR) 3 mg/g. GFR estimated using the IDMS-traceable 4-variable Modification of Diet in Renal Disease (MDRD) Study equation or Chronic Kidney Disease Epidemiology Collaboration equation (-EPI) for calibrated serum creatinine (Scr) values STAGES Stage 1: egfr 9 ml/min/1.73 m 2, and ACR 3 mg/g Stage 2: egfr 6 89 ml/min/1.73 m 2, and ACR 3 mg/g Stage 3: egfr 3 59 ml/min/1.73 m 2 Stage 4: egfr 15 29 ml/min/1.73 m 2 Stage 5: egfr <15 ml/min/1.73 m 2 ANEMIA WHO Male: hemoglobin <13 g/dl Female: <12g/dl KDOQI (26) Males: hemoglobin <13.5 g/dl Women <12g/dl BODY MASS INDEX CATEGORIES UW: underweight, BMI <18.5 N: normal, BMI 18.5 24.9 OW: overweight, BMI 25 29.9 OB: obese, BMI 3 39.9 EOB: extremely obese, BMI 4 EDUCATIONAL STATUS GSL: Grade school or less HSG: High school graduate SC+: Some college, college graduate, post graduate Am J Kidney Dis. 212;59(3)(suppl 2):S4-S64 S41
Program accessibility cumulative # of partic. (in 1,s) 15 125 1 75 5 25 5 138,65 48 Cumulative # of affiliates 25-1 2 3 4 5 6 7 8 9 1-1 2 3 4 5 6 7 8 9 1 45 4 35 3 s.1 Cumulative number of eligible participants & affiliates, by year (2 21), N = 138,65 s.2 Geographic variations in the percent of participants, by state (2 21), N = 138,65 Percent of participants 3.42 + ( 4.89) 1.85 to <3.42.92 to <1.85.38 to <.92 Below.38 (.13) South Carolina Florida Indiana Utah Greater New York Western Pennsylvania Mass./Rhode Isl./N. Hampshire/Vermont Virginia Louisiana East Tennessee Connecticut Kentucky North Carolina National Capital Area Georgia Arizona Minnesota North Texas Hawaii Ohio 1 2 3 4 5 6 Percent of participants s.3 Twenty largest affiliates, by percentage of participants screened (rank order) (2 21), N = 95,813 S42 Am J Kidney Dis. 212;59(3)(suppl 2):S4-S64
Program accessibility s.a Total eligible participants, by year (2 21), N = 138,65 Age 2+21 22 23 24 25 26 27 28 29 21 All All (%) 18-3 568 644 1,4 1,85 1,391 1,257 989 1,77 1,19 71 9,735 7. 31-45 1,491 1,977 2,393 2,939 3,984 3,685 2,87 3,4 2,697 2,135 27,175 19.6 46-6 2,97 2,651 3,422 4,69 6,438 6,592 5,59 6,113 5,949 4,824 48,285 34.8 61-75 1,52 2,29 2,382 3,328 4,769 5,111 4,968 5,562 5,575 4,663 39,889 28.8 >75 424 743 721 1,76 1,547 1,656 1,683 1,938 1,959 1,774 13,521 9.8 Missing............ Gender Male 1,959 2,57 2,944 4,142 5,879 5,684 5,27 5,85 5,547 4,464 44,21 31.9 Female 4,123 5,473 6,976 8,975 12,192 12,613 1,88 11,889 11,65 9,629 94,328 68.1 Missing. 1 2 1 58 4 4. 2 4 76.1 Race White 2,284 3,14 4,31 5,793 9,28 9,8 8,131 9,261 8,738 7,251 66,899 48.3 Black 2,652 3,392 3,43 4,274 5,267 5,565 5,41 5,42 5,479 4,476 44,978 32.5 Native American 324 575 686 818 723 434 346 153 275 132 4,466 3.2 Asian 172 263 423 477 952 1,228 851 1,76 875 85 7,167 5.2 Pacific Islander 55 133 113 45 92 24 12 114 52 75 715.5 Other 416 387 629 1,629 1,647 1,256 1,123 1,37 1,78 1,255 11,357 8.2 Unknown/missing 179 19 34 82 42 786 515 381 72 58 3,23 2.2 Ethnicity Hispanic 618 712 1,117 1,89 2,416 2,317 2,75 2,163 2,317 1,851 17,476 12.6 Non-Hispanic 5,464 7,332 8,85 11,228 15,713 15,984 13,944 15,531 14,882 12,246 121,129 87.4 Education Level <12 years 948 1,277 1,42 2,2 2,83 2,782 2,469 2,454 2,353 1,758 2,293 14.6 12 years 1,585 2,192 2,591 3,491 4,611 4,462 4,19 4,531 4,527 3,73 35,91 25.9 >12 years 1,629 2,155 2,775 3,459 4,675 4,351 3,815 4,54 4,272 3,56 35,141 25.4 16 years 1,143 1,463 1,913 2,53 3,614 3,814 3,228 3,682 3,738 3,274 28,399 2.5 >16 years 688 862 1,132 1,467 2,145 2,453 2,19 2,299 2,117 1,769 16,951 12.2 Missing 89 95 91 169 254 439 297 224 192 6 1,91 1.4 Health Insurance Status Yes 4,948 6,428 7,892 1,153 14,56 14,27 12,44 13,631 12,579 1,577 16,875 77.1 No 883 1,234 1,66 2,49 3,251 3,371 3,292 3,525 3,88 3,196 26,782 19.3 Missing 251 382 37 475 822 723 318 536 74 323 4,94 3.6 All 6,82 8,44 9,922 13,118 18,129 18,31 16,19 17,694 17,199 14,97 138,65 1 "." Zero values in this cell Am J Kidney Dis. 212;59(3)(suppl 2):S4-S64 S43
Targeting high-risk populations % with self-reported diabetes 4 3 2 1 29.9 6.9 NHANES 99-6 All 18-3 31-45 46-6 61-75 75+ s.4 Self-reported diabetes in & NHANES participants (2 21), N= 137,765 NHANES (1999 26), N= 22,66 5 s.5 participants with diabetes Percent with diabetes 4 3 2 1 31.3 (2 21), N= 138,58 All 18-3 31-45 46-6 61-75 75+ White Black Oth Hisp NHisp Percent aware 1 8 6 4 2 95. s.6 participants with diabetes who are aware of their condition (2 21), N= 43,314 All 18-3 31-45 46-6 61-75 75+ Percent treated 6 5 4 3 2 1 47.3 s.7 participants with diabetes who receive medication for their condition (2 21), N= 43,314 All 18-3 31-45 46-6 61-75 75+ S44 Am J Kidney Dis. 212;59(3)(suppl 2):S4-S64
Targeting high-risk populations Percent with glycemic control 1 8 6 4 2 All 18-3 31-45 46-6 61-75 75+ s.8 Glycemic control in participants with diabetes (2 21), N= 43,314 Percent with glycemic control 1 8 6 4 2 59.9 All 18-3 31-45 46-6 61-75 75+ s.9 Glycemic control in participants with diabetes who are being treated for their condition (2 21), N= 2,487 Percent with glycemic control 1 8 6 4 2 7.9 All 18-3 31-45 46-6 61-75 75+ s.1 Glycemic control in participants with diabetes who are not being treated for their condition (2 21), N= 22,827 Am J Kidney Dis. 212;59(3)(suppl 2):S4-S64 S45
Targeting high-risk populations s.11 % with self-reported hypertension 8 6 4 2 56.4 26.9 NHANES 99-6 All 18-3 31-45 46-6 61-75 75+ Self-reported hypertension in & NHANES participants (2 21), N= 136,922 NHANES (1999 26), N= 22,366 s.12 1 participants with hypertension Percent with hypertension 8 6 4 2 7.4 (2 21), N= 138,588 All 18-3 31-45 46-6 61-75 75+ Percent aware 1 8 6 4 2 s.13 participants with hypertension who are aware of their condition (2 21), N= 97,567 All 18-3 31-45 46-6 61-75 75+ Percent treated 1 8 6 4 2 62.1 s.14 participants with hypertension who receive medication for their condition (2 21), N= 97,567 All 18-3 31-45 46-6 61-75 75+ S46 Am J Kidney Dis. 212;59(3)(suppl 2):S4-S64
Targeting high-risk populations s.15 4 Blood pressure control in participants with hypertension Percent controlled 3 2 1 26.8 (2 21), N= 97,567 All 18-3 31-45 46-6 61-75 75+ Percent controlled 5 4 3 2 1 32.2 s.16 Blood pressure control in participants with hypertension who are being treated for their condition (2 21), N= 6,553 All 18-3 31-45 46-6 61-75 75+ Percent controlled 4 3 2 1 18. s.17 Blood pressure control in participants with hypertension not being treated for their condition (2 21), N= 37,14 All 18-3 31-45 46-6 61-75 75+ Am J Kidney Dis. 212;59(3)(suppl 2):S4-S64 S47
Targeting high-risk populations % with self-reported high chol. 1 8 6 4 2 5.7 38.7 NHANES 99-6 NHANES: age 2-3 All 18-3 31-45 46-6 61-75 75+ s.18 Self-reported high cholesterol in & NHANES participants (2 21), N= 69,463 NHANES (1999 26), N= 13,535 Percent with high cholesterol 1 8 6 4 2 62.2 All 18-3 31-45 46-6 61-75 75+ s.19 participants with high cholesterol (2 21), N= 94,28 Percent aware 1 8 6 4 2 6.1 s.2 participants with high cholesterol who are aware of their condition (2 21), N= 58,623 All 18-3 31-45 46-6 61-75 75+ Percent treated 6 4 2 32.6 s.21 participants with high cholesterol who receive medication for their condition (2 21), N= 58,623 All 18-3 31-45 46-6 61-75 75+ S48 Am J Kidney Dis. 212;59(3)(suppl 2):S4-S64
Targeting high-risk populations Percent controlled 5 4 3 2 1 31.6 s.22 Cholesterol control in participants with high cholesterol (2 21), N= 58,623 All 18-3 31-45 46-6 61-75 75+ Percent controlled 1 8 6 4 2 7.2 s.23 Cholesterol control in participants with high cholesterol who are being treated for their condition (2 21), N= 19,118 All 18-3 31-45 46-6 61-75 75+ Percent controlled 2 15 1 5 12.9 s.24 Cholesterol control in participants with high cholesterol who are not being treated for their condition (2 21), N= 39,55 All 18-3 31-45 46-6 61-75 75+ Am J Kidney Dis. 212;59(3)(suppl 2):S4-S64 S49
Targeting high-risk populations s.25 % with self-reported CVD 5 4 3 2 1 Age 23. Gender Race/ethnicity Self-reported cardiovascular disease in participants (2 21), N= 135,582 All 18-3 31-45 46-6 61-75 75+ White Black Other Hisp OW: 33.1 NHANES 99-6 N: 21.4 UW:.9 OW: 33.6 EO: 8.9 N: 32.8 UW: 1.9 EOB: 5.1 s.26 Percent distribution of & NHANES participants, by BMI (2 21), N= 137,5 NHANES (1999 26), N= 2,567 OB: 35.67 OB: 26.5 S5 Am J Kidney Dis. 212;59(3)(suppl 2):S4-S64
Prevalence of 75 Age: MDRD Gender Race/ethnicity s.27 Prevalence of in & NHANES participants Percent with 5 25.9 25 15.3 -EPI 75 NHANES 99-6 (2 21), N= 124,41 NHANES (1999 26), N= 19,553 5 25 23.7 14.1 NHANES 99-6 All 18-3 31-45 46-6 61-75 75+ White Black Other Hisp Percent with microalbuminuria 3 2 1 11.7 9.6 NHANES 99-6 All 18-3 31-45 46-6 61-75 75+ White Black Other Hisp s.28 Prevalence of microalbuminuria in & NHANES participants (2 21), N= 127,593 NHANES (1999 26), N= 2,573. Am J Kidney Dis. 212;59(3)(suppl 2):S4-S64 S51
Prevalence of s.b Total eligible participants with, by stage: MDRD equation (2 21), N= 138,65 Stage 1 & Stage 2 & Non- Abnormal ACR Abnormal ACR Stage 3 Stages 4-5 Missing All Age 18-3 7,489 462 198 139 17 1,43 9,735 31-45 2,465 97 942 1,129 68 3,61 27,175 46-6 34,634 1,43 2,46 4,927 243 5,32 48,285 61-75 23,799 617 2,174 9,551 468 3,28 39,889 >75 5,584 115 848 5,635 438 91 13,521 Gender Male 29,64 1,52 2,158 6,3 459 4,628 44,21 Female 62,367 2,515 4,5 15,81 775 9,54 94,328 Missing..... 76 76 Race White 43,417 1,65 2,911 14,79 714 4,713 66,899 Black 3,731 1,629 2,121 4,624 34 5,569 44,978 Native American 2,791 226 247 598 59 545 4,466 Asian 5,32 194 32 776 63 494 7,167 Pacific Islander 421 23 63 117 13 78 715 Other 8,392 385 493 1,96 78 913 11,357 Unknown/missing 899 45 53 91 3 1,932 3,23 Ethnicity Hispanic 12,121 595 66 1,446 94 2,56 17,476 Non-Hispanic 79,85 2,972 5,548 19,935 1,14 11,684 121,129 U.S. Census Region Northeast 22,7 834 1,526 5,154 281 3,63 32,928 Midwest 13,617 537 923 3,442 192 1,989 2,7 South 42,78 1,725 2,84 9,198 525 7,435 64,53 West 13,483 471 919 3,581 236 1,746 2,436 Missing 21.. 6. 11 38 U.S. Census Division New England 7,113 241 483 1,95 89 1,666 11,497 Middle Atlantic 14,957 593 1,43 3,249 192 1,397 21,431 East North Central 8,619 374 595 1,953 11 1,3 12,654 West North Central 4,998 163 328 1,489 82 986 8,46 South Atlantic 22,14 877 1,444 4,824 258 4,279 33,696 East South Central 11,37 46 766 2,578 128 1,369 16,617 West South Central 9,396 442 63 1,796 139 1,787 14,19 Mountain 7,683 248 492 2,431 128 924 11,96 Pacific 5,8 223 427 1,15 18 822 8,53 Missing 21.. 6. 11 38 Smoking Yes 34,397 1,483 2,657 8,724 548 5,571 53,38 No 54,736 1,952 3,365 11,984 647 7,812 8,496 Missing 2,838 132 186 673 39 861 4,729 Education Level < 12 years 12,256 654 1,71 3,595 269 2,448 2,293 12 years 22,935 97 1,78 6,328 385 3,584 35,91 >12 years 23,65 927 1,516 5,91 293 3,664 35,141 16 years 2,23 677 1,146 3,537 162 2,647 28,399 >16 years 11,87 294 664 2,55 11 1,526 16,951 Missing 1,92 45 13 28 15 375 1,91 Health Insurance Status Yes 69,623 2,366 4,791 18,275 1,31 1,789 16,875 No 19,388 1,59 1,21 2,224 148 2,762 26,782 Missing 2,952 142 216 882 55 693 4,94 Doctor Status Yes 79,143 2,967 5,563 2,72 1,15 11,841 12,736 No 11,175 523 535 948 56 1,928 15,165 Missing 1,653 77 11 361 28 475 2,74 All 91,971 3,567 6,28 21,381 1,234 14,244 138,65 "." Zero values in this cell S52 Am J Kidney Dis. 212;59(3)(suppl 2):S4-S64
Prevalence of 3 2 MDRD 25.9 15.3 NHANES 99-6 s.29 Prevalence of in & NHANES participants, by stage (2 21), N= 124,41 NHANES (1999 26), N= 19,553 1 Percent with 3 2 -EPI 23.7 NHANES 99-6 14.1 1 All Stage 1 Stage 2 Stage 3 Stages 4-5 s.3 1 8 6 MDRD NHANES 99-6 Prevalence of in & NHANES participants, by risk factor (2 21), N= 123,463 NHANES (1999 26), N= 19,354 Percent with 4 2 1 25.8 -EPI 15.3 8 6 4 2 23.6 14.1 NHANES 99-6 All No /DM /HTN /DM/HTN /Other Am J Kidney Dis. 212;59(3)(suppl 2):S4-S64 S53
Prevalence of s.c Total eligible participants with, by stage: -EPI equation (2 21), N= 138,65 Stage 1 & Stage 2 & Non- Abnormal ACR Abnormal ACR Stage 3 Stages 4-5 Missing All Age 18-3 7,542 578 92 69 15 1,439 9,735 31-45 2,958 1,414 575 486 66 3,676 27,175 46-6 36,85 1,843 1,87 3,173 213 5,164 48,285 61-75 24,873 74 2,17 8,262 476 3,368 39,889 >75 5,239 43 854 5,984 543 858 13,521 Gender Male 3,83 1,35 1,968 5,668 58 4,669 44,21 Female 64,614 3,313 3,53 12,36 85 9,76 94,328 Missing..... 76 76 Race White 45,515 1,515 2,664 11,544 754 4,97 66,899 Black 3,859 1,947 1,827 4,426 349 5,57 44,978 Native American 2,884 284 221 459 6 558 4,466 Asian 5,437 256 29 612 62 51 7,167 Pcific Islander 446 42 5 79 12 86 715 Other 8,635 522 394 791 73 942 11,357 Unknown/missing 921 52 52 63 3 1,932 3,23 Ethnicity Hispanic 12,433 767 547 1,39 9 2,6 17,476 Non-Hispanic 82,264 3,851 4,951 16,935 1,223 11,95 121,129 U.S. Census Region Northeast 22,719 1,67 1,375 4,338 298 3,131 32,928 Midwest 14,56 692 826 2,919 27 2, 2,7 South 43,9 2,26 2,487 7,768 569 7,573 64,53 West 14,1 653 81 2,943 239 1,79 2,436 Missing 21.. 6. 11 38 U.S. Census Division New England 7,414 314 442 1,525 93 1,79 11,497 Middle Atlantic 15,35 753 933 2,813 25 1,422 21,431 East North Central 8,848 47 539 1,668 119 1,1 12,654 West North Central 5,28 222 287 1,251 88 99 8,46 South Atlantic 22,574 1,13 1,261 4,9 276 4,365 33,696 East South Central 11,72 53 674 2,178 148 1,385 16,617 West South Central 9,624 546 552 1,5 145 1,823 14,19 Mountain 8,47 337 446 2,9 133 934 11,96 Pacific 5,954 316 364 934 16 856 8,53 Missing 21.. 6. 11 38 Smoking Yes 35,415 1,96 2,365 7,425 589 5,68 53,38 No 56,369 2,556 2,96 9,968 683 7,96 8,496 Missing 2,913 156 173 581 41 865 4,729 Education Level <12 years 12,481 774 991 3,26 31 2,477 2,293 12 years 23,649 1,211 1,565 5,416 416 3,653 35,91 >12 years 24,379 1,228 1,319 4,26 293 3,716 35,141 16 years 2,883 942 948 2,746 163 2,717 28,399 >16 years 12,187 41 584 2,12 114 1,563 16,951 Missing 1,117 62 91 244 17 379 1,91 Health Insurance Status Yes 71,769 3,57 4,327 15,612 1,114 1,996 16,875 No 19,899 1,396 97 1,571 14 2,86 26,782 Missing 3,21 165 21 791 59 73 4,94 Doctor Status Yes 81,569 3,849 4,966 17,46 1,233 12,73 12,736 No 11,428 683 418 633 53 1,95 15,165 Missing 1,7 86 114 295 27 482 2,74 All 94,697 4,618 5,498 17,974 1,313 14,55 138,65 "." Zero values in this cell S54 Am J Kidney Dis. 212;59(3)(suppl 2):S4-S64
as a disease multiplier s.31 5 4 MDRD:, Age 41.4 No Gender Race/ethnicity Self-reported diabetes in & NHANES participants with or without 3 2 26.5 (2 21), N= 122,453 NHANES (1999 26), N= 19,542 1 5 NHANES 99-6 Percent with self-reported diabetes 4 3 2 1 5 4 3 2 1 19.7 4.6 * -EPI: 42.7 26.5 No NHANES 99-6 5 4 3 2 1 2.6 4.6 * All 18-3 31-45 46-6 61-75 75+ White Black Other Hisp Am J Kidney Dis. 212;59(3)(suppl 2):S4-S64 S55
as a disease multiplier 1 8 6 4 2 1 8 6 MDRD:, 73.9 NHANES 99-6 52. 51.3 No s.32 Self-reported hypertension in & NHANES participants with or without (2 21), N= 121,762 NHANES (1999 26),N= 19,36 Percent with self-reported hypertension 4 2 1 8 6 4 2 1 8 6 4 2 -EPI: 75.6 22.6 NHANES 99-6 53.1 51.5 22.9 No All 18-3 31-45 46-6 61-75 75+ White Black Other Hisp S56 Am J Kidney Dis. 212;59(3)(suppl 2):S4-S64
as a disease multiplier 1 8 6 4 2 1 MDRD:, 62. 47.2 NHANES 99-6 No s.33 Self-reported high cholesterol in & NHANES participants with or without (2 21), N= 66,279 NHANES (2 29), N= 11,781 Percent with self-reported high cholesterol 8 6 4 2 1 8 6 4 2 1 8 48.3 -EPI: 62.2 37.2 47.5 NHANES 99-6 NHANES: age 2-3 No NHANES: age 2-3 6 4 2 49 37 All 18-3 31-45 46-6 61-75 75+ White Black Other Hisp Am J Kidney Dis. 212;59(3)(suppl 2):S4-S64 S57
as a disease multiplier 5 4 3 MDRD: Age 34.2 No Gender Race/ethnicity s.34 Self-reported cardiovascular disease in KEEp participants with or without (2 21), N= 124,41 2 2.3 % with self-reported CVD 1 5 4 3 -EPI 33.1 No 2 2.3 1 All 18-3 31-45 46-6 61-75 75+ White Black Other Hisp 8 6 4 MDRD:, Age 46.4 44. No Gender s.35 BMI 3 kg/m 2 in & NHANES participants with or without (2 21), N= 122,756 NHANES (1999 26), N=19,148 2 8 NHANES 99-6 6 Percent with BMI>= 3kg/m 2 4 2 8 6 4 37.7 3.6 -EPI: 46.2 44.1 No 2 8 NHANES 99-6 6 4 38.2 3.6 2 All 18-45 46-6 61+ Male Female S58 Am J Kidney Dis. 212;59(3)(suppl 2):S4-S64
as a disease multiplier % of participants with anemia 3 2 1 3 2 MDRD: WHO anemia 12.2 -EPI 5.4 NHANES 99-6 NHANES 99-6 KDOQI anemia 14.3 6.4 s.36 Anemia (WHO & KDOQI definitions) in & NHANES participants with or without (2 21), N= 122,461 NHANES (1999 26), N= 19,533 1 12.2 5.4 14.3 6.4 All No All No 8 6 4 2 8 MDRD: WHO anemia NHANES 99-6 Male Female 9.4 13.4 3. 7.7 KDOQI anemia * s.37 Anemia (WHO & KDOQI definitions) in & NHANES participants (2 21), N= 122,461 NHANES (1999 26), MDRD, N= 19,533, -EPI, N=19,536 6 4 Percent of participants with anemia 2 8 6 4 2 8 16. 13.4 5.1 7.7 -EPI : WHO anemia KODQI anemia Male Female 9.4 13.4 3. 7.7 * * 6 4 2 16. 13.4 5.1 7.7 * All No Stg 1 Stg 2 Stg 3 Stgs 4-5 All No Stg 1 Stg 2 Stg 3 Stgs 4-5 Am J Kidney Dis. 212;59(3)(suppl 2):S4-S64 S59
as a disease multiplier s.d Odds ratio (OR) of, by risk factor (2 21), N= 62,715 MDRD equation OR Low Upper P-value Age 18-45.74.69.79 <.1 46-6 1. 61-75 1.84 1.75 1.93 <.1 75+ 4.33 4.6 4.62 <.1 Male.93.9.97. Race White 1. Black.64.61.67 <.1 Native American 1.7.92 1.24.37 Asian.66.59.72 <.1 Other 1.17 1.6 1.29. Hispanic.65.59.71 <.1 Self-reported diabetes 1.42 1.36 1.48 <.1 Self-reported hypertension 1.76 1.68 1.84 <.1 Self-reported high cholestrol 1.11 1.6 1.15 <.1 Cardiovascular disease 1.25 1.19 1.3 <.1 2 1.14 1.1 1.19 <.1 Anemia (WHO definition) 2.9 1.98 2.21 <.1 Insurance.95.9 1..5 -EPI equation OR Low Upper P-value Age 18-45.83.78.89 <.1 46-6 1. 61-75 2.7 1.96 2.18 <.1 75+ 6.29 5.88 6.72 <.1 Male 1.4.99 1.8.13 Race White 1. Black.79.75.83 <.1 Native American 1.19 1.2 1.38.3 Asian.71.64.79 <.1 Other 1.18 1.7 1.31. Hispanic.7.64.77 <.1 Self-reported diabetes 1.48 1.42 1.55 <.1 Self-reported hypertension 1.79 1.71 1.88 <.1 Self-reported high cholestrol 1.9 1.5 1.14 <.1 Cardiovascular disease 1.27 1.22 1.33 <.1 2 1.15 1.1 1.2 <.1 Anemia (WHO definition) 2.22 2.1 2.35 <.1 Insurance.93.88.98.1 S6 Am J Kidney Dis. 212;59(3)(suppl 2):S4-S64
Education & insurance SC: 25.7 HSG: 26.3 CG: 2.8 GSL/SHS 14.8 PG: 12.4 NHANES 99-6 HSG: 26.1 GSL: 2.7 SC+: 53.2 s.38 Percent distribution of & NHANES participants, by educational status (2 21), N= 136,694 NHANES (1999 26), N= 22,553 Percent with insurance 1 Age 77.1 81.9 NHANES 99-6 8 6 4 2 Gender s.39 Insurance coverage in & NHANES participants (2 21), N= 138,597 NHANES (1999 26), N= 22,3 All 18-3 31-45 46-6 61-75 75+ Non- Medicare: 38.1 Mcare with other than Mcaid: 12.2 Medicare 11.6 Unknown or missing: 34.8 Mcare/Mcaid: 3.2 s.4 Percent distribution of types of insurance in participants reporting they have insurance (2 21), N= 138,65 Percent with insurance 1 8 6 4 2 NHANES White Black Other Hispanic s.41 Insurance coverage in & NHANES participants (2 21), N= 1 35,574 race, N= 138,597 ethnicity NHANES (1999 26), N= 22,3 Am J Kidney Dis. 212;59(3)(suppl 2):S4-S64 S61
RRT & mortality outcomes s.e Hazard ratio of RRT, controlled by risk factors (2 21), N= 11,423 s.f Hazard ratio of death, controlled by risk factors (2 21), N= 11,417 Estimate SE P-value Hazard ratio Age 18-45.31.14.33 1.36 46-6 1. 61-75 -.6.11 <.1.55 75+ -1.8.15 <.1.34 Male.64.9 <.1 1.89 Race White 1. Black.47.11 <.1 1.6 Native American.53.18.39 1.7 Asian.3.2.145 1.35 Other.7.21.7366 1.7 Hispanic -.27.21.1943.76 Self-reported diabetes.48.1 <.1 1.62 Self-reported hypertension.48.16.19 1.62 Cardiovascular disease.14.9.159 1.15 BMI 3 kg/m 2.2.1.8254 1.2 Anemia (WHO definition).92.1 <.1 2.5 Insurance -.7.13.5629.93 egfr(continuous) -.9. <.1.92 ACR 3mg/g 2.26.13 <.1 9.6 MDRD Study Equation Estimate SE P-value Hazard ratio Age 18-45 -.96.9 <.1.38 46-6 1. 61-75.9.5 <.1 2.45 75+ 1.83.6 <.1 6.25 Male.56.3 <.1 1.75 Race White 1. Black -.7.4.8.93 Native American.37.7 <.1 1.44 Asian -.37.9 <.1.69 Other -.31.11.1.74 Hispanic -.24.9.1.79 Self-reported diabetes.34.4 <.1 1.41 Self-reported hypertension.16.4. 1.17 Cardiovascular disease.51.4 <.1 1.66 BMI 3 kg/m 2 -.6.4.9.94 Anemia (WHO definition).57.4 <.1 1.77 Insurance -.18.6..84 by MDRD non- 1. stage 1.76.1 <.1 2.14 stage 2.67.6 <.1 1.95 stage 3-5.59.4 <.1 1.81 -EPI Equation Estimate SE P-value Hazard ratio Age 18-45 -.96.9 <.1.38 46-6 1. 61-75.88.5 <.1 2.41 75+ 1.77.6 <.1 5.87 Male.55.3 <.1 1.73 Race White 1. Black -.1.4.2.91 Native American.36.7 <.1 1.44 Asian -.38.9 <.1.69 Other -.31.11.1.73 Hispanic -.24.9.1.79 Self-reported diabetes.34.4 <.1 1.41 Self-reported hypertension.15.4. 1.17 Cardiovascular disease.51.4 <.1 1.66 BMI 3 kg/m 2.94 Anemia (WHO definition).6. <.1 1.74 Insurance -.18.6..83 by -EPI non- 1. stage 1.75.9 <.1 2.13 stage 2.7.6 <.1 2.1 stage 3-5.64.4 <.1 1.9 S62 Am J Kidney Dis. 212;59(3)(suppl 2):S4-S64
RRT & mortality outcomes Rate per 1, person years 3. 2.5 2. 1.5 1..5. 1.4 All 18-3 31-45 46-6 61-75 75+ White Black Other Hisp s.42 Rates of renal replacement therapy (RRT) in participants (2 21), N= 119,718 Rate per 1, person years 1 8 6 4 2 MDRD equation Stage 1 Stage 2 Stages 3-5 -EPI equation Stage 1 Stage 2 Stages 3-5 Rate per 1, person years 4 3 2 1 8.1 All 18-3 31-45 46-6 61-75 75+ White Black Other Hisp s.43 Mortality rates in participants (2 21), N= 122,641 Rate per 1, patient years 3 2 1 MDRD equation Stage 1 Stage 2 Stages 3-5 -EPI equation Stage 1 Stage 2 Stages 3-5 Am J Kidney Dis. 212;59(3)(suppl 2):S4-S64 S63
Access, follow-up & intervention Percent with a physician 1 8 6 4 2 Age 88.2 Gender Race/ethnicity s.44 participants with a physician (2 21), N= 135,91 All 18-3 31-45 46-6 61-75 75+ WhiteBlackOther Hisp NHisp % completing followup form 5 4 3 2 1 2+21 22 23 24 25 26 27 28 29 21 s.45 follow-up response rate (%) (2 21), N=138,68 Reasons for seeing a physician (%) 6 4 2 BP Glucose Urine egfr Hgb Cholesterol Other s.46 Reasons for seeing a physician in participants who return their follow-up forms (2 21), N= 35,275 S64 Am J Kidney Dis. 212;59(3)(suppl 2):S4-S64