Impact of CKD Progression on Cardiovascular Disease Risk in a Contemporary UK Cohort of Individuals With Diabetes
| Autor: | Volker Schnecke, Peter J. Greasley, Alison S. Lee, Marcus Lind, Klara Westman, Marita Olsson, Stanko Skrtic, Claudia Cabrera |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2020 |
| Předmět: |
medicine.medical_specialty
hypertension Heart disease Population 030232 urology & nephrology heart disease 030204 cardiovascular system & hematology lcsh:RC870-923 03 medical and health sciences 0302 clinical medicine Clinical Research Internal medicine medicine Risk factor education education.field_of_study diabetes business.industry Hazard ratio medicine.disease lcsh:Diseases of the genitourinary system. Urology Confidence interval Nephrology Cohort epidemiology business statistical Mace chronic kidney disease Kidney disease |
| Zdroj: | Kidney International Reports, Vol 5, Iss 10, Pp 1651-1660 (2020) Kidney International Reports |
| ISSN: | 2468-0249 |
| Popis: | Introduction It remains unclear whether an increased progression rate of chronic kidney disease (CKD) adds predictive information regarding cardiovascular disease (CVD) risk. The aim of this study was to evaluate the association between CKD progression, based on estimated glomerular filtration rate (eGFR) slope estimates and the risk for CVD. Methods We compared the updated eGFR slope calculated over multiple overlapping 2-year periods and the updated mean eGFR. Incident CKD subjects were selected from a prevalent population with diabetes (T2DM). Subjects from the UK Clinical Practice Research Data Link GOLD (CPRD) were followed from CKD diagnosis (n = 30,222) until heart failure (HF), myocardial infarction (MI), ischemic stroke (IS), or a composite end point including all 3 event types (MACE plus), mortality, database dropout, or end of study follow-up. Results Both the updated eGFR slope and updated mean eGFR were associated with MACE plus and HF. Updated eGFR slope decline of > –3 ml/min/1.73 m2 increased the risk for MACE plus (adjusted hazard ratio [HR] = 1.45; 95% confidence interval [CI], 1.26–1.67), HF (HR = 1.50; 95% CI, 1.27–1.76), and MI (HR = 1.39; 95% CI, 1.01–1.91). Conclusions This study strongly supports current evidence that CKD is an independent risk factor for CVD. From a clinical perspective, both rate of progression and cumulative status of CKD describe distinct aspects of the cardiorenal risk among persons with diabetes. This evidence is essential to enable more timely and improved use of treatments in this population. Graphical abstract |
| Databáze: | OpenAIRE |
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