Kidney Disease and Cardiovascular Risk: Whether Black or White Race Matters

Chronic kidney disease (CKD) is common and consequential.¹ It is estimated that 6% to 8% of noninstitutionalized US adults have a glomerular filtration rate of less than 60 mL/min per 1.73 m² (consistent with CKD stage 3a or worse) and nearly 10% have albuminuria.² Both persistently reduced glomerular filtration rate (usually estimated from creatinine and demographic factors) and kidney damage (usually assessed with urine albumin-to-creatinine ratio [ACR]) are strong and independent risk factors for mortality and cardiovascular events, leading some to consider CKD to be a coronary heart disease (CHD) risk equivalent.³ Although the concerning increase in the prevalence of CKD has been recognized for some time,² recent data indicate that the number of deaths from CKD have doubled between 1990 and 2010.⁴