{"doi":"10.1093/ndt/gfaa364","title":"Clinical events and patient-reported outcome measures during CKD progression: findings from the Chronic Renal Insufficiency Cohort Study","abstract":"BACKGROUND: Patients with chronic kidney disease (CKD) face risks of not only end-stage kidney disease (ESKD), cardiovascular disease (CVD) and death, but also decline in kidney function, quality of life (QOL) and mental and physical well-being. This study describes the multidimensional trajectories of CKD using clinical events, kidney function and patient-reported outcome measures (PROMs). We hypothesized that more advanced CKD stages would associate with more rapid decline in each outcome. METHODS: Among 3939 participants enrolled in the Chronic Renal Insufficiency Cohort (CRIC) Study, we evaluated multidimensional disease trajectories by G- and A-stages of enrollment estimated glomerular filtration rate (eGFR) and albuminuria, respectively. These trajectories included clinical events (ESKD, CVD, heart failure and death), eGFR decline and PROMs [kidney disease QOL (KDQOL) burden, effects and symptoms questionnaires, as well as the 12-item short form mental and physical component summaries]. We also evaluated a group-based multitrajectory model to group participants on the basis of longitudinal PROMs and compared group assignments by enrollment G- and A-stage. RESULTS: The mean participant age was 58 years, 45% were women, mean baseline eGFR was 44 mL/min/1.73 m2 and median urine albumin:creatinine ratio was 52 mg/g. The incidence of all clinical events was greater and eGFR decline was faster with more advanced G- and A-stages. While baseline KDQOL and physical component measures were lower with more advanced G- and A-stage of CKD, changes in PROMs were inconsistently related to the baseline CKD stage. Groups formed on PROM trajectories were fairly distinct from existing CKD staging (observed agreement 60.6%) and were associated with the risk of ESKD, CVD, heart failure and death. CONCLUSIONS: More advanced baseline CKD stage was associated with a higher risk of clinical events and faster eGFR decline, and was only weakly related to changes in patient-reported metrics over time.","journal":"Nephrology Dialysis Transplantation","year":2020,"id":63876,"datarank":0.0,"base_score":0.0,"endowment":0.0,"self_citation_contribution":0.0,"citation_network_contribution":0.0,"self_endowment_contribution":0.0,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":41,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.9548,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2020-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":232664,"name":"Aditya Surapaneni","orcid":"0000-0003-4978-5980","position":1,"is_corresponding":false},{"id":277163,"name":"Lawrence J. Appel","orcid":"0000-0002-0673-6823","position":2,"is_corresponding":false},{"id":277166,"name":"James P. Lash","orcid":"0000-0002-6580-4080","position":3,"is_corresponding":false},{"id":337715,"name":"Jesse Y. Hsu","orcid":"0000-0002-1522-6534","position":4,"is_corresponding":false},{"id":277169,"name":"Clarissa J. Diamantidis","orcid":"0000-0001-8212-6288","position":5,"is_corresponding":false},{"id":231212,"name":"Sylvia E. Rosas","orcid":"0000-0002-9903-4002","position":6,"is_corresponding":false},{"id":277167,"name":"Jeffrey C. Fink","orcid":"0000-0002-5622-5052","position":7,"is_corresponding":false},{"id":281085,"name":"Julia J. Scialla","orcid":"0000-0003-1707-691X","position":8,"is_corresponding":false},{"id":337716,"name":"James Sondheimer","orcid":"0000-0002-9538-9682","position":9,"is_corresponding":false},{"id":19021,"name":"Chi‐yuan Hsu","orcid":"0000-0001-8182-1238","position":10,"is_corresponding":false},{"id":290913,"name":"Alfred K. Cheung","orcid":"0000-0002-7304-9476","position":11,"is_corresponding":false},{"id":337717,"name":"Bernard G. Jaar","orcid":"0000-0003-1210-7115","position":12,"is_corresponding":false},{"id":236350,"name":"Sankar D. Navaneethan","orcid":"0000-0002-4953-7795","position":13,"is_corresponding":false},{"id":283063,"name":"Debbie L. Cohen","orcid":"0000-0002-1325-315X","position":14,"is_corresponding":false},{"id":228813,"name":"Sarah J. Schrauben","orcid":"0000-0003-2557-5161","position":15,"is_corresponding":false},{"id":318716,"name":"Dawei Xie","orcid":"0000-0002-5065-7305","position":16,"is_corresponding":false},{"id":338562,"name":"P. Jagannadha Rao","orcid":null,"position":17,"is_corresponding":false},{"id":58429,"name":"Harold I. Feldman","orcid":"0000-0003-4572-2608","position":18,"is_corresponding":false},{"id":283357,"name":"the CRIC Study Investigators","orcid":null,"position":19,"is_corresponding":false},{"id":249669,"name":"Alan S. Go","orcid":"0000-0001-9109-0811","position":20,"is_corresponding":false},{"id":24759,"name":"Jiang He","orcid":"0000-0002-8286-9652","position":21,"is_corresponding":false},{"id":277171,"name":"Mahboob Rahman","orcid":"0000-0001-9025-7413","position":22,"is_corresponding":false},{"id":232678,"name":"Raymond R. Townsend","orcid":"0000-0002-3215-9118","position":23,"is_corresponding":false},{"id":73169,"name":"Morgan E. Grams","orcid":"0000-0002-4430-6023","position":0,"is_corresponding":true}],"reference_count":46,"raw_metadata":null,"created_at":"2026-07-18T21:11:24.000992Z","pmid":"33326030","pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}