J Korean Med Sci.  2017 Feb;32(2):221-230. 10.3346/jkms.2017.32.2.221.

Baseline General Characteristics of the Korean Chronic Kidney Disease: Report from the KoreaN Cohort Study for Outcomes in Patients With Chronic Kidney Disease (KNOW-CKD)

• Kang E
• Han M
• Kim H
• Park SK
• Lee J
• Hyun YY
• Kim YS
• Chung W
• Kim HJ
• Oh YK
• Ahn C
• Oh KH

• KMID: 2364165
• DOI: http://doi.org/10.3346/jkms.2017.32.2.221

Abstract

The KoreaN Cohort Study for Outcomes in Patients With Chronic Kidney Disease (KNOW-CKD) was developed to investigate various clinical courses and risk factors for progression of Korean chronic kidney disease (CKD). The KNOW-CKD study consists of nine clinical centers in Korea, and patients aged between 20 and 75 years with CKD from stage 1 to 5 (predialysis) were recruited. At baseline, blood and urine samples were obtained and demographic data including comorbidities, drugs, quality of life, and health behaviors were collected. Estimated glomerular filtration rate (eGFR) was calculated by 4-variable Modification of Diet in Renal Disease (MDRD) equation using isotope dilution mass spectrometry (IDMS)-calibrated serum creatinine measured at a central laboratory. As a dynamic cohort, a total of 2,341 patients were enrolled during the enrollment period from 2011 until 2015, among whom 2,238 subjects were finally analyzed for baseline profiles. The mean age of the cohort was 53.7 ± 12.2 year and 61.2% were men. Mean eGFR was 50.5 ± 30.3 mL/min/1.73 m². The participants with lower eGFR had a tendency to be older, with more comorbidities, to have higher systolic blood pressure (BP) and pulse pressure, with lower income level and education attainment. The patients categorized as glomerulonephritis (GN) were 36.2% followed by diabetic nephropathy (DN, 23.2%), hypertensive nephropathy (HTN, 18.3%), polycystic kidney disease (PKD, 16.3%), and other unclassified disease (6.1%). The KNOW-CKD participants will be longitudinally followed for 10 years. The study will provide better understanding for physicians regarding clinical outcomes, especially renal and cardiovascular outcomes in CKD patients.

Keyword

Chronic Kidney Disease; Cohort; Diabetes; Hypertension; Polycystic Kidney Disease; Glomerulonephritis; Epidemiology

MeSH Terms

Blood Pressure
Cohort Studies*
Comorbidity
Creatinine
Diabetic Nephropathies
Diet
Education
Epidemiology
Glomerular Filtration Rate
Glomerulonephritis
Health Behavior
Humans
Hypertension
Korea
Male
Mass Spectrometry
Polycystic Kidney Diseases
Quality of Life
Renal Insufficiency, Chronic*
Risk Factors
Creatinine

Figure

• 

  Fig. 1 Participants' recruitment and follow-up flow diagram. IDMS = isotope dilution mass spectrometry, Cr = creatinine.

• 

  Fig. 2 Collection of clinical specimens in KNOW-CKD cohort. KNOW-CKD = KoreaN Cohort Study for Outcomes in Patients With Chronic Kidney Disease, rpm = revolution per minute.

Reference

1. Anavekar NS, McMurray JJ, Velazquez EJ, Solomon SD, Kober L, Rouleau JL, White HD, Nordlander R, Maggioni A, Dickstein K, et al. Relation between renal dysfunction and cardiovascular outcomes after myocardial infarction. N Engl J Med. 2004; 351:1285–1295.

2. Go AS, Chertow GM, Fan D, McCulloch CE, Hsu CY. Chronic kidney disease and the risks of death, cardiovascular events, and hospitalization. N Engl J Med. 2004; 351:1296–1305.

3. Taskapan H, Tam P, Au V, Chow S, Fung J, Nagai G, Roscoe J, Ng P, Sikaneta T, Ting R, et al. Improvement in eGFR in patients with chronic kidney disease attending a nephrology clinic. Int Urol Nephrol. 2008; 40:841–848.

4. Nakamura S, Nakata H, Yoshihara F, Kamide K, Horio T, Nakahama H, Kawano Y. Effect of early nephrology referral on the initiation of hemodialysis and survival in patients with chronic kidney disease and cardiovascular diseases. Circ J. 2007; 71:511–516.

5. Jones C, Roderick P, Harris S, Rogerson M. Decline in kidney function before and after nephrology referral and the effect on survival in moderate to advanced chronic kidney disease. Nephrol Dial Transplant. 2006; 21:2133–2143.

6. Levin A, Rigatto C, Brendan B, Madore F, Muirhead N, Holmes D, Clase CM, Tang M, Djurdjev O. CanPREDDICT investigators. Cohort profile: Canadian study of prediction of death, dialysis and interim cardiovascular events (CanPREDDICT). BMC Nephrol. 2013; 14:121.

7. Ricardo AC, Lash JP, Fischer MJ, Lora CM, Budoff M, Keane MG, Kusek JW, Martinez M, Nessel L, Stamos T, et al. Cardiovascular disease among hispanics and non-hispanics in the chronic renal insufficiency cohort (CRIC) study. Clin J Am Soc Nephrol. 2011; 6:2121–2131.

8. Mehrotra R, Kermah D, Fried L, Adler S, Norris K. Racial differences in mortality among those with CKD. J Am Soc Nephrol. 2008; 19:1403–1410.

9. Rodriguez CJ, Sciacca RR, Diez-Roux AV, Boden-Albala B, Sacco RL, Homma S, DiTullio MR. Relation between socioeconomic status, race-ethnicity, and left ventricular mass: the Northern Manhattan study. Hypertension. 2004; 43:775–779.

10. Gutiérrez OM, Anderson C, Isakova T, Scialla J, Negrea L, Anderson AH, Bellovich K, Chen J, Robinson N, Ojo A, et al. Low socioeconomic status associates with higher serum phosphate irrespective of race. J Am Soc Nephrol. 2010; 21:1953–1960.

11. Imai E, Matsuo S, Makino H, Watanabe T, Akizawa T, Nitta K, Iimuro S, Ohashi Y, Hishida A; CKD-JAC Study Group. Chronic kidney disease Japan cohort (CKD-JAC) study: design and methods. Hypertens Res. 2008; 31:1101–1107.

12. Imai E, Matsuo S, Makino H, Watanabe T, Akizawa T, Nitta K, Iimuro S, Ohashi Y, Hishida A. Chronic kidney disease Japan cohort study: baseline characteristics and factors associated with causative diseases and renal function. Clin Exp Nephrol. 2010; 14:558–570.

13. Feldman HI, Appel LJ, Chertow GM, Cifelli D, Cizman B, Daugirdas J, Fink JC, Franklin-Becker ED, Go AS, Hamm LL, et al. The Chronic renal insufficiency cohort (CRIC) study: design and methods. J Am Soc Nephrol. 2003; 14:S148–53.

14. Lash JP, Go AS, Appel LJ, He J, Ojo A, Rahman M, Townsend RR, Xie D, Cifelli D, Cohan J, et al. Chronic renal insufficiency cohort (CRIC) study: baseline characteristics and associations with kidney function. Clin J Am Soc Nephrol. 2009; 4:1302–1311.

15. Oh KH, Park SK, Park HC, Chin HJ, Chae DW, Choi KH, Han SH, Yoo TH, Lee K, Kim YS, et al. KNOW-CKD (KoreaN cohort study for outcome in patients with chronic kidney disease): design and methods. BMC Nephrol. 2014; 15:80.

16. Levey AS, Coresh J, Greene T, Marsh J, Stevens LA, Kusek JW, Van Lente F; Chronic Kidney Disease Epidemiology Collaboration. Expressing the modification of diet in renal disease study equation for estimating glomerular filtration rate with standardized serum creatinine values. Clin Chem. 2007; 53:766–772.

17. Levey AS, Coresh J, Greene T, Stevens LA, Zhang YL, Hendriksen S, Kusek JW, Van Lente F; Chronic Kidney Disease Epidemiology Collaboration. Using standardized serum creatinine values in the modification of diet in renal disease study equation for estimating glomerular filtration rate. Ann Intern Med. 2006; 145:247–254.

18. Pei Y, Obaji J, Dupuis A, Paterson AD, Magistroni R, Dicks E, Parfrey P, Cramer B, Coto E, Torra R, et al. Unified criteria for ultrasonographic diagnosis of ADPKD. J Am Soc Nephrol. 2009; 20:205–212.

19. Charlson ME, Pompei P, Ales KL, MacKenzie CR. A new method of classifying prognostic comorbidity in longitudinal studies: development and validation. J Chronic Dis. 1987; 40:373–383.

20. Park HJ, Kim S, Yong JS, Han SS, Yang DH, Meguro M, Han CW, Kohzuki M. Reliability and validity of the Korean version of kidney disease quality of life instrument (KDQOL-SF). Tohoku J Exp Med. 2007; 211:321–329.

21. Hull S, Dreyer G, Badrick E, Chesser A, Yaqoob MM. The relationship of ethnicity to the prevalence and management of hypertension and associated chronic kidney disease. BMC Nephrol. 2011; 12:41.

22. Chen J, Muntner P, Hamm LL, Jones DW, Batuman V, Fonseca V, Whelton PK, He J. The metabolic syndrome and chronic kidney disease in U.S. adults. Ann Intern Med. 2004; 140:167–174.

23. Fox CS, Larson MG, Leip EP, Culleton B, Wilson PW, Levy D. Predictors of new-onset kidney disease in a community-based population. JAMA. 2004; 291:844–850.

24. Kramer H, Luke A, Bidani A, Cao G, Cooper R, McGee D. Obesity and prevalent and incident CKD: the hypertension detection and follow-up program. Am J Kidney Dis. 2005; 46:587–594.