What question did this study set out to answer?

This study aims to estimate the burden of cardiovascular disease attributable to chronic kidney disease and how it varies by population characteristics.

February 8, 2026

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Cardiovascular disease burden attributable to decreased estimated glomerular filtration rate: insights from the ATTICA study (2002-2022)

Key Points

This study aims to estimate the burden of cardiovascular disease attributable to chronic kidney disease and how it varies by population characteristics.
Analyzed data from 1,988 adults free of cardiovascular disease from the ATTICA study (2002-2022)
Calculated estimated glomerular filtration rate using the Chronic Kidney Disease Epidemiology Collaboration equation
Defined chronic kidney disease as eGFR≤60 mL/min/1.73m2 following KDIGO guidelines
Assessed combined fatal or non-fatal cardiovascular disease events at multiple time points
Computed population attributable fractions using Miettinen’s formula and performed stratified analyses.
CKD prevalence at baseline was 4.7% among participants.
20-year cardiovascular disease incidence was 36.12%, significantly higher in those with CKD (77% vs. 34%, p<0.001).
Approximately 6 out of 100 new cardiovascular cases could be prevented with proper CKD management.
Extrapolating data suggests that reducing CKD by 30% could prevent 144 million cardiovascular cases globally.
Differences in cardiovascular disease burden were observed based on sex and comorbidities.

Abstract

Abstract Background/Introduction Despite the strong pathophysiologic and epidemiologic link between chronic kidney disease (CKD) and cardiovascular disease (CVD) (usually referred to as cardiorenal syndrome), there is low population awareness concerning CKD. Moreover, specific estimates for CKD's contribution to CVD are sparsely reported. Purpose Thus, this study aimed to estimate CVD burden attributable to CKD and whether this burden varies in participants with different population characteristics. Methods Our sample included 1,988 adults initially free-of-CVD who took part in the ATTICA study (2002-2022). Estimated glomerular filtration rate (eGFR) was calculated based on the Chronic Kidney Disease Epidemiology Collaboration equation. CKD was defined in 2002, according to Kidney Disease Improving Global Outcomes (KDIGO) guidelines, as an eGFR≤60 mL/min/1.73m2 (i.e., at least stage 3). Combined fatal or non-fatal CVD events were assessed in 2006, 2012 and 2022 based on WHO-ICD-10. Population attributable fractions for multiadjusted models were computed based on Miettinen’s formula. Stratified analyses were also performed. Results At baseline, the prevalence of CKD was 4.7% (n=94). The 20-year CVD incidence was 36.12% (n=713); it was higher in those who had CKD compared to those who did not (i.e., 77% vs. 34%, p0.001). Approximately 6 out of a 100 new CVD cases (95%CI: 1.7%, 8.1%) would have been prevented if CKD had been adequately managed. If this number was extrapolated to the 8 billion people living in the world, even if the aim was to reduce CKD by 30% (and not completely), this could still mean the prevention of 144 million CVD cases worldwide. Furthermore, variations in these fractions were observed by sex and presence of comorbidities. Conclusion Albeit more research is warranted, our study supports that CKD should become a public health priority, and specifically a CVD priority.

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Cite This Study

Damigou et al. (Sat,) studied this question.

synapsesocial.com/papers/698828990fc35cd7a88482b3 https://doi.org/https://doi.org/10.1093/eurheartj/ehaf784.3440

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