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Original ArticlesChronic Kidney Disease
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Chronic Renal Insufficiency Cohort (CRIC) Study: Baseline Characteristics and Associations with Kidney Function

James P. Lash, Alan S. Go, Lawrence J. Appel, Jiang He, Akinlolu Ojo, Mahboob Rahman, Raymond R. Townsend, Dawei Xie, Denise Cifelli, Janet Cohan, Jeffrey C. Fink, Michael J. Fischer, Crystal Gadegbeku, L. Lee Hamm, John W. Kusek, J. Richard Landis, Andrew Narva, Nancy Robinson, Valerie Teal and Harold I. Feldman
CJASN August 2009, 4 (8) 1302-1311; DOI: https://doi.org/10.2215/CJN.00070109
James P. Lash
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Alan S. Go
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Lawrence J. Appel
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Jiang He
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Akinlolu Ojo
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Mahboob Rahman
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Raymond R. Townsend
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Dawei Xie
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Denise Cifelli
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Janet Cohan
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Jeffrey C. Fink
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Michael J. Fischer
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Crystal Gadegbeku
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L. Lee Hamm
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John W. Kusek
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J. Richard Landis
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Andrew Narva
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Nancy Robinson
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Valerie Teal
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Harold I. Feldman
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    Figure 1.

    Particpant recruitment and follow-up flow diagram. *Five participants with estimated GFR above the exclusion level were scheduled and completed the baseline visit in error.

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    Table 1.

    Sequence and schedule of CRIC Study clinic visits/contacts and proceduresa

    ParameterVisit
    ScreeningBaseline6 mo12 mo18 mo24 mo30 mo36 mo42 mo48 mo54 mo60 mo
    Type of contactVisitVisitPhoneVisitPhoneVisitPhoneVisitPhoneVisitPhoneVisit
    Informed consent•
    Medical record consent••••
    Contact information••••••••••••
    Labs: creatinine, glucose•
    Demographic information•
    Eligibility confirmation•
    Medical history••••••
    Genetic blood sample••••••
    Labs: CBC, metabolic panel, lipids••••••
    24-h urine••••••
    BP••••••
    Anthropometric measures••••••
    Ankle brachial index••••••
    Bioelectric impedance assessment••••••
    Nail clippings••••••
    Electrocardiogram••••••
    Echocardiogram••
    EBT or MDCT (one third subcohort)••
    Iothalamate-GFR (one third subcohort)•••
    Pulse wave velocity••
    Physical assessment•••
    Medications•••••••
    KDQOL quality of life (43)••••••
    Diet History Questionnaire (44)•••
    Mini Mental Status Exam (45)•••
    MDRD Symptom Index (46)••••••
    Beck Depression Inventory (47)•••
    Physical Activity (48,49)•••
    Kansas City Questionnaire (50)•••••
    Recent medical history•••••••••••
    • ↵a CBC, complete blood count; CRIC, Chronic Renal Insufficiency Cohort; EBT, electron-beam tomography; MDCT, multidetector computed tomography; MDRD, Modification of Diet in Renal Disease; KDQOL, Kidney Disease Quality of Life.

    • View popup
    Table 2.

    Eligibility and exclusion criteria

    Eligibility criteria
        Age stratum (yr)/eligible eGFR range (ml/min per 1.73 m2)a
            21 to 44/20 to 70
            45 to 64/20 to 60
            65 to 74/20 to 50
    Exclusion criteria
        institutionalized (e.g., prisoner, nursing home or skilled nursing facility resident)
        unable or unwilling to give consent
        unlikely or unable to participate in required study procedures
        New York Heart Association class III or IV heart failure (baseline)
        known cirrhosis
        known HIV infection and/or AIDS
        pregnant women
        previously received dialysis for {my]1 mo
        previous organ or bone marrow transplant
        received immunosuppressive or other immunotherapy for primary renal disease or systemic vasculitis within the past 6 mo
        previous chemotherapy or alkylating agents for systemic cancer other than non-melanoma skin cancer within 2 yr
        previous diagnosis of multiple myeloma or renal carcinoma
        polycystic kidney disease
        current participation in interventional clinical trial or in a research study
    • ↵a Based on simplified Modification of Diet in Renal Disease (MDRD) equation.

    • View popup
    Table 3.

    Baseline demographic and clinical characteristics of participantsa

    VariableCohort(n = 3612)Subcohort with iGFR (n = 1288)Diabetes(n = 1683)No Diabetes(n = 1929)P for Diabetes versus No Diabetes
    Age (yr; mean ± SD)58.2 ± 11.056.1 ± 12.559.5 ± 9.857.1 ± 11.80.0001
    Gender (n [%])0.2516
        male1959 (54)713 (55)931 (55)1028 (53)
        female1653 (46)575 (45)754 (45)899 (47)
    Racial/ethnic group (n [%])0.0001
        non-Hispanic white1638 (45)713 (46)931 (39)1028 (51)0.2516
        non-Hispanic black/African American1651 (46)532 (41)849 (50)802 (42)
        Hispanic169 (5)69 (5)111 (7)58 (3)
        otherb154 (4)99 (8)76 (5)78 (4)0.0001
    Annual household income (n [%])0.0001
        ≤$20,0001009 (28)297 (23)565 (34)444 (23)
        $20,001 to $50,000906 (25)338 (26)432 (26)474 (24)
        $50,001 to $100,000725 (20)306 (24)281 (17)444 (23)
        >$100,000389 (11)153 (12)134 (8)255 (13)
        no response583 (16)193 (15)271 (16)312 (16)
    Educational attainment (n [%])0.0001
        <7th grade60 (2)16 (1)41 (2)19 (1)
        7th to 12th grade545 (15)153 (12)319 (19)226 (12)
        high school diploma695 (19)239 (19)339 (20)356 (18)
        vocational degree184 (5)64 (5)98 (6)86 (4)
        some college921 (26)319 (25)440 (26)481 (25)
        college graduate696 (19)298 (23)281 (17)415 (22)
        graduate degree510 (14)198 (15)167 (10)343 (18)
    Tobacco use (n [%])
        current smoker494 (14)151 (12)212 (13)282 (15)0.0733
        >100 cigarettes during lifetime2019 (56)667 (52)983 (58)1036 (54)0.0057
    Medical history (n [%])
        hypertension3094 (86)1091 (85)1552 (92)1542 (80)0.0001
        MI or coronary revascularization810 (22)225 (17)493 (29)317 (17)0.0001
        chronic heart failure357 (10)86 (7)245 (15)112 (6)0.0001
        PAD250 (7)80 (6)181 (11)69 (4)0.0001
    BP variables
        SBP (mmHg; mean ± SD)127.7 ± 21.9127.8 ± 21.3132.4 ± 22.5123.6 ± 20.50.0001
        DBP (mmHg; mean ± SD)71.4 ± 12.872.4 ± 12.769.4 ± 12.973.1 ± 12.80.0001
        MAP (mmHg; mean ± SD)90.2 ± 13.890.9 ±13.290.4 ± 13.989.9 ± 13.60.3113
        BP >130/80 mmHg (n [%])1686 (47)626 (49)882 (53)804 (42)0.0001
    Weight (kg; mean ± SD)92.0 ± 23.789.9 ± 21.297.7 ± 24.287.1 ± 22.10.0001
    BMI (kg/m2; mean ± SD)32.1 ± 7.931.3 ± 7.034.1 ± 8.230.3 ± 7.20.0001
    BMI (kg/m2; n [%])0.0001
        <25.0607 (17)234 (18)179 (11)428 (22)
        25.0 to 29.91017 (28)380 (30)388 (23)629 (33)0.0001
        >30.01987 (55)673 (52)1118 (67)869 (45)
    ABI<0.9 (n [%])526 (15)173 (14)335 (20)191 (10)0.0001
    Kidney function measures
        adjusted serum creatinine(mg/dl; mean ± SD)1.73 ± 0.571.68 ± 0.561.80 ± 0.561.66 ± 0.560.0001
        eGFR (ml/min/1.73 m2; mean ± SD)43.4 ± 13.545.2 ± 14.141.4 ± 12.945.1 ± 13.80.0001
        eGFR (ml/min/1.73 m2; n [%])
            <153 (0)2 (0)1 (0)2 (0)0.0001
            15 to 29664 (18)206 (16)351 (21)313 (16)
            30 to 592532 (70)887 (69)1197 (71)1335 (70)
            60 to 89389 (11)187 (15)126 (8)263 (14)
            >908 (0)4 (0)4 (0)4 (0)
        urine protein/24 h (g; median (IQR)0.17 (0.07 to 0.81)0.18 (0.07 to 0.90)0.32 (0.09 to 1.49)0.11 (0.06 to 0.43)0.0001
        ACEI or ARB therapy (n [%])2462 (68)880 (68)1336 (79)1126 (58)0.0001
    Lipoproteins (mg/dl; mean ± SD)
        total cholesterol183.0 ± 44.5183.8 ± 47.1177.0 ± 47.2188.2 ± 41.30.0001
        LDL cholesterol102.5 ± 35.0103.4 ± 36.696.4 ± 36.4107.8 ± 33.70.0001
        HDL cholesterol48.1 ± 15.647.5 ± 15.745.7 ± 13.950.2 ± 16.80.0001
        triglycerides154.2 ± 115.6152.2 ± 112.5166.2 ± 130.3143.6 ± 99.80.0001
    Hemoglobin (g/dl; mean ± SD)12.7 ± 1.812.6 ± 1.712.1 ± 1.713.2 ± 1.70.0001
    Serum calcium (mg/dl; mean ± SD)9.2 ± 0.59.2 ± 0.59.1 ± 0.59.2 ± 0.50.0001
    Serum phosphorus (mg/dl; mean ± SD)3.7 ± 0.73.7 ± 0.73.9 ± 0.73.6 ± 0.60.0001
    Total PTH (pg/ml; median [IQR])53.0 (34.0 to 88.0)52.9 (34.0 to 85.0)60.0 (37.1 to 102.4)48.5 (32.5 to 78.0)0.0001
    Blood glucose (mg/dl; median [IQR])97.0 (86.0 to 124.0)97.0 (86.0 to 121.0)127.0 (100.0 to 163.0)90.0 (84.0 to 98.0)0.0001
    Glycosylated hemoglobin (%; mean ± SD6.6 ± 1.66.6 ± 1.67.7 ± 1.75.7 ± 0.50.0001
    • ↵a ABI, ankle-brachial index; ACEI, angiotensin-converting enzyme inhibitor; ARB, angiotensin receptor blocker; BMI, body mass index; DBP, diastolic BP; eGFR, estimated GFR; iPTH, intact parathyroid hormone; IQR, interquartile range; MAP, mean arterial pressure; MI, myocardial infarction; PAD, peripheral arterial disease; SB{, systolic BP.

    • ↵b Includes Asian/Pacific Islander and Native American individuals.

    • View popup
    Table 4.

    Baseline characteristics by eGFR level

    VariableeGFR (ml/min per 1.73 m2)P
    <3030 to <4040 to <5050 to <60≥60
    n667844968720397
    Age (yr; mean ± SD)58.7 ± 11.259.6 ± 11.060.0 ± 10.457.7 ± 10.151.5 ± 11.00.0001
    Gender (n [%])0.0001
        male311 (47)440 (52)568 (59)406 (56)226 (57)
        female356 (53)404 (48)400 (41)314 (44)171 (43)
    Racial/ethnic group (n [%])0.0673
        non-Hispanic white277 (42)386 (46)461 (48)348 (48)160 (40)
        non-Hispanic black/African American303 (45)387 (46)430 (44)319 (44)202 (51)
        Hispanic55 (8)43 (5)32 (3)21 (3)18 (5)
        othera32 (5)28 (3)45 (5)32 (4)17 (4)0.0001
    Annual household income (n [%])0.1435
        ≤$20,000249 (37)292 (35)232 (24)155 (22)72 (18)
        $20,001 to $50,000179 (27)199 (24)267 (28)162 (23)96 (24)
        $50,001 to $100,000103 (17)150 (18)187 (19)171 (24)108 (27)
        >$100,00038 (6)69 (8)117 (12)115 (16)49 (12)
        no response93 (14)134 (16)165 (17)117 (16)72 (18)
    Educational attainment (n [%])0.0001
        <7th grade27 (4)15 (2)10 (1)4 (1)2 (1)
        7th to 12th grade126 (18)160 (19)143 (15)82 (11)27 (7)
        high school diploma145 (22)177 (21)189 (20)112 (16)69 (17)
        vocational degree36 (5)38 (5)48 (5)36 (5)26 (7)
        some college162 (24)224 (27)228 (24)192 (27)112 (28)
        college graduate106 (16)146 (17)188 (19)172 (24)82 (21)
        graduate degree65 (10)84 (10)162 (17)122 (17)76 (19)
    Tobacco use (n [%])
        current smoker110 (16)122 (15)117 (12)84 (12)54 (14)0.0001
        >100 cigarettes during lifetime405 (61)500 (59)542 (56)375 (52)139 (48)0.0189
    Medical history (n [%])
        hypertension612 (92)767 (91)848 (88)587 (82)267 (67)0.0001
        diabetes352 (53)459 (54)448 (46)290 (40)130 (33)0.0001
        MI or coronary revascularization170 (26)227 (27)227 (23)131 (18)51 (13)0.0001
        chronic heart failure97 (15)103 (12)91 (10)43 (6)19 (5)0.0001
        PAD75 (11)85 (10)47 (5)31 (4)11 (4)0.0001
    BP variables.
        SBP (mmHg; mean ± SD)130.5 ± 23.6129.4 ± 23.2127.7 ± 21.3125.4 ± 20.2123.5 ± 20.00.0001
        DBP (mmHg; mean ± SD)69.9 ± 13.370.0 ± 12.671.5 ± 12.772.3 ± 12.374.9 ± 12.80.0001
        MAP (mmHg; mean ± SD)90.1 ± 14.489.8 ± 14.090.2 ± 13.790.0 ± 13.191.1 ± 13.60.6042
        BP >130/80 (mmHg; n [%])335 (50)394 (47)466 (48)319 (45)164 (42)0.0001
    Weight (kg; mean ± SD)89.8 ± 24.892.3 ± 23.292.5 ± 23.393.3 ± 24.192.4 ± 22.60.0311
    BMI (kg/m2; mean ± SD)31.9 ± 8.432.5 ± 7.932.1 ± 7.832.2 ± 8.131.3 ± 7.10.2313
    BMI category (kg/m2; n [%])0.9367
        <25.0134 (20)128 (15)150 (15)121 (17)74 (19)
        25.0 to 29.9182 (27)238 (28)275 (28)206 (29)112 (28)0.0001
        >30353 (53)480 (57)544 (56)392 (55)212 (54)
    ABI <0.9142 (22)149 (18)125 (13)93 (13)15 (4)0.0001
    Roche adjusted creatinine (mean ± SD)2.56 ± 0.561.90 ± 0.321.56 ± 0.231.32 ± 0.201.14 ± 0.200.0001
    Urine protein/24 h (g; median [IQR])0.58 (0.15 to 2.14)0.26 (0.08 to 1.22)0.13 (0.07 to 0.60)0.10 (0.06 to 0.36)0.10 (0.06 to 0.22)0.0001
    Lipoproteins
        total cholesterol (mg/dl; mean ± SD)183.3 ± 51.2182.5 ± 46.2183.1 ± 42.1183.2 ± 41.3183.5 ± 39.60.8297
        LDL cholesterol (mg/dl; mean ± SD)99.7 ± 37.9100.2 ± 35.3103.1 ± 34.6104.4 ± 33.3107.3 ± 32.60.0001
        HDL cholesterol (mg/dl; mean ± SD)46.9 ± 15.547.4 ± 15.848.2 ± 14.948.8 ±16.050.2 ± 16.40.0004
        triglycerides (mg/dl; mean ± SD)168.1 ± 127.2163.0 ± 123.4151.4 ± 99.6148.5 ± 127.2129.9 ± 81.60.0001
    Hemoglobin (g/dl; mean ± SD)11.8 ± 1.712.3 ± 1.712.8 ± 1.713.2 ± 1.613.4 ± 1.60.0001
    Serum calcium (mg/dl; mean ± SD)9.1 ± 0.69.2 ± 0.59.2 ± 0.59.2 ± 0.59.2 ± 0.40.0002
    Total iPTH (pg/ml; median [IQR])105.0 (64.0 to 172.0)63.9 (41.0 to 100.0)47.5 (32.0 to 74.0)41.0 (29.7 to 59.1)36.0 (27.3 to 50.3)0.0001
    Serum phosphorus(mg/dl; mean ± SD)4.1 ± 0.83.8 ± 0.63.6 ± 0.63.5 ± 0.63.4 ± 0.50.0001
    Blood glucose (mg/dl; median [IQR])97.0 (85.0 to 124.0)98.0 (87.0 to 131.0)100.0 (88.0 to 127.0)95.0 (85.0 to 119.0)94.0 (84.0 to 110.0)0.0003
    Glycosylated hemoglobin(%; mean ± SD)6.7 ± 1.56.8 ± 1.66.7 ± 1.56.5 ± 1.46.3 ± 1.70.0001
    Serum uric acid (mg/dl; mean ± SD)8.2 ± 2.07.9 ± 1.97.3 ± 1.86.8 ± 1.66.2 ± 1.70.0001
    • ↵a Includes Asian/Pacific Islander and Native American individuals.

    • View popup
    Table 5.

    Select anticipated and actual recruitment targets: Race/ethnic target distribution in CRIC Study

    Race/Ethnic GroupAnticipated (%)Actual (%)
    Non-Hispanic white47.5045.34
    Non-Hispanic black47.5045.92
    Othera5.008.75
    • ↵a For the purposes of recruitment goal, other group includes Hispanic, Asian/Pacific Islander, and Native American individuals.

    • View popup
    Table 6.

    Select anticipated and actual recruitment targets: Age- and diabetes-status distribution in CRIC Study

    Age Stratum (yr)Anticipated Recruitment (%)Actual Recruitment Cohort (%)
    No DiabetesDiabetesNo DiabetesDiabetes
    21 to 4412.5012.509.513.99
    45 to 6425.0025.0029.7227.75
    65 to 7412.5012.5014.5614.47
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Clinical Journal of the American Society of Nephrology
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Chronic Renal Insufficiency Cohort (CRIC) Study: Baseline Characteristics and Associations with Kidney Function
James P. Lash, Alan S. Go, Lawrence J. Appel, Jiang He, Akinlolu Ojo, Mahboob Rahman, Raymond R. Townsend, Dawei Xie, Denise Cifelli, Janet Cohan, Jeffrey C. Fink, Michael J. Fischer, Crystal Gadegbeku, L. Lee Hamm, John W. Kusek, J. Richard Landis, Andrew Narva, Nancy Robinson, Valerie Teal, Harold I. Feldman
CJASN Aug 2009, 4 (8) 1302-1311; DOI: 10.2215/CJN.00070109

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Chronic Renal Insufficiency Cohort (CRIC) Study: Baseline Characteristics and Associations with Kidney Function
James P. Lash, Alan S. Go, Lawrence J. Appel, Jiang He, Akinlolu Ojo, Mahboob Rahman, Raymond R. Townsend, Dawei Xie, Denise Cifelli, Janet Cohan, Jeffrey C. Fink, Michael J. Fischer, Crystal Gadegbeku, L. Lee Hamm, John W. Kusek, J. Richard Landis, Andrew Narva, Nancy Robinson, Valerie Teal, Harold I. Feldman
CJASN Aug 2009, 4 (8) 1302-1311; DOI: 10.2215/CJN.00070109
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  • Apparent Treatment-Resistant Hypertension Assessed by Office and Ambulatory Blood Pressure in Chronic Kidney Disease--A Report from the Chronic Renal Insufficiency Cohort Study
  • Anemia and Incident End-Stage Kidney Disease
  • Progression of retinopathy and incidence of cardiovascular disease: findings from the Chronic Renal Insufficiency Cohort Study
  • Association of 24-Hour Ambulatory Blood Pressure Patterns with Cognitive Function and Physical Functioning in CKD
  • Kidney Clearance of Secretory Solutes Is Associated with Progression of CKD: The CRIC Study
  • Serum Calcification Propensity and Clinical Events in CKD
  • Cardiac and Stress Biomarkers and Chronic Kidney Disease Progression: The CRIC Study
  • Impact of AKI on Urinary Protein Excretion: Analysis of Two Prospective Cohorts
  • Burden and Outcomes of Heart Failure Hospitalizations in Adults With Chronic Kidney Disease
  • Sex-Related Disparities in CKD Progression
  • Cardiovascular Events after New-Onset Atrial Fibrillation in Adults with CKD: Results from the Chronic Renal Insufficiency Cohort (CRIC) Study
  • Patient Experience with Primary Care Physician and Risk for Hospitalization in Hispanics with CKD
  • Variations in 24-Hour BP Profiles in Cohorts of Patients with Kidney Disease around the World: The I-DARE Study
  • Self-Reported Tobacco, Alcohol, and Illicit Drug Use and Progression of Chronic Kidney Disease
  • Association of Pulse Wave Velocity With Chronic Kidney Disease Progression and Mortality: Findings From the CRIC Study (Chronic Renal Insufficiency Cohort)
  • Time-Centered Approach to Understanding Risk Factors for the Progression of CKD
  • Central Blood Pressure and Cardiovascular Outcomes in Chronic Kidney Disease
  • BP Measurement in Clinical Practice: Time to SPRINT to Guideline-Recommended Protocols
  • Statistical Methods for Recurrent Event Analysis in Cohort Studies of CKD
  • The Association of Sleep Duration and Quality with CKD Progression
  • Patterns of NSAIDs Use and Their Association with Other Analgesic Use in CKD
  • Statistical Methods for Modeling Time-Updated Exposures in Cohort Studies of Chronic Kidney Disease
  • Fibroblast Growth Factor 23 and Anemia in the Chronic Renal Insufficiency Cohort Study
  • Association of QT-Prolonging Medication Use in CKD with Electrocardiographic Manifestations
  • Blood Pressure and Risk of Cardiovascular Events in Patients on Chronic Hemodialysis: The CRIC Study (Chronic Renal Insufficiency Cohort)
  • Statistical Methods for Cohort Studies of CKD: Survival Analysis in the Setting of Competing Risks
  • Statistical Methods for Cohort Studies of CKD: Prediction Modeling
  • Risk Factors for Heart Failure in Patients With Chronic Kidney Disease: The CRIC (Chronic Renal Insufficiency Cohort) Study
  • Urine Kidney Injury Biomarkers and Risks of Cardiovascular Disease Events and All-Cause Death: The CRIC Study
  • Genome-Wide Association of CKD Progression: The Chronic Renal Insufficiency Cohort Study
  • CKD Progression and Mortality among Hispanics and Non-Hispanics
  • Measurement Error as Alternative Explanation for the Observation that CrCl/GFR Ratio is Higher at Lower GFR
  • Social Determinants of Racial Disparities in CKD
  • Antihypertensive Medication in Patients Pre- and Postdialysis: Still Hazy After All These Years
  • Atrial Fibrillation and Risk of ESRD in Adults with CKD
  • Predictors and Outcomes of Health-Related Quality of Life in Adults with CKD
  • Health-Related Quality of Life in CKD--Advancing Patient-Centered Research to Transform Patient Care
  • Change in Measured GFR Versus eGFR and CKD Outcomes
  • Ankle Brachial Index and Subsequent Cardiovascular Disease Risk in Patients With Chronic Kidney Disease
  • Masked Hypertension and Elevated Nighttime Blood Pressure in CKD: Prevalence and Association with Target Organ Damage
  • Genetic African Ancestry and Markers of Mineral Metabolism in CKD
  • Urinary Sodium and Potassium Excretion and CKD Progression
  • Prevalence, Predictors, and Outcomes of Pulmonary Hypertension in CKD
  • Sex Differences in the Incidence of Peripheral Artery Disease in the Chronic Renal Insufficiency Cohort
  • Prevalence and Prognostic Significance of Apparent Treatment Resistant Hypertension in Chronic Kidney Disease: Report From the Chronic Renal Insufficiency Cohort Study
  • Human Heredity and Health (H3) in Africa Kidney Disease Research Network: A Focus on Methods in Sub-Saharan Africa
  • Chronic Renal Insufficiency Cohort Study (CRIC): Overview and Summary of Selected Findings
  • Kansas City Cardiomyopathy Questionnaire Score Is Associated With Incident Heart Failure Hospitalization in Patients With Chronic Kidney Disease Without Previously Diagnosed Heart Failure: Chronic Renal Insufficiency Cohort Study
  • Elevated Serum Bicarbonate Concentration in Chronic Kidney Disease: A Call to Find the Cause
  • Persistent High Serum Bicarbonate and the Risk of Heart Failure in Patients With Chronic Kidney Disease (CKD): A Report From the Chronic Renal Insufficiency Cohort (CRIC) Study
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