Participants will be eligible for inclusion if they (1) have CKD (glomerular filtration rate (GFR) < 60 ml/min per 1.73 m2) stages 2 to 5, and (2) ages of 18 to 74 years. Patients undergoing hemodialysis (HD) or peritoneal dialysis (PD) will be also invited to participate. The study is designed to use a population control as reference group. Eligible controls will be asymptomatic subjects without CKD. Participants will be excluded for any of the following reasons: (1) had prior CVD, (2) received a kidney transplant, (3) had a life-threatening disease, such as cancer, (4) underwent previous carotid artery surgery, or (5) have an ABI < 0.7 and/or a carotid artery stenosis greater than 75% at baseline.
We will use the Modification of Diet in Renal Disease Study (MDRD) and the Chronic Kidney disease Epidemiology Collaboration (CKD-EPI) equations to estimate the GFR to classify patients into the different stages of CKD [25 (link),26 (link)]. Patients switching stage or dialytic modality in the follow-up of this study will be considered and these data will be registered at each visit. Only patients who switch to kidney transplant will be excluded from the follow-up. Enrollment will be stratified by hospital according to the prevalence of CKD patients in each stage, in order to obtain a sample in which all Spanish regions would be represented. Details about centers and geographical distribution can be seen at the website of the NEFRONA study http://www.nefrona.es.
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