Methods: In this retrospective analysis of a prospective observational cohort, we analyzed health checkup data from 3, 377 residents aged 40 years living in Takahata, Japan. Baseline data were collected between 2004 and 2006. Eligibility for inclusion required an estimated glomerular filtration rate (eGFR) of 30 mL/min/1. 73m 2 at baseline. The primary and secondary endpoints were all-cause mortality and cardiovascular events, respectively. Participants were stratified according to the presence or absence of HHcy and mild-to-moderate CKD. Cumulative incidence of the endpoints was assessed using the Kaplan-Meier method, and the risk of events was evaluated by Cox proportional hazards regression analysis. Results: The median follow-up period was 18. 6 years (interquartile range, 17. 2-19. 3). Kaplan-Meier analyses revealed that individuals with both HHcy and CKD had the highest incidence of all-cause mortality and cardiovascular events (log-rank p < 0. 001 for both). After adjustment for cardiovascular risk factors, this group remained at the highest risk, with hazard ratios (HRs) of 2. 49 (95% confidence interval (CI), 2. 00-3. 10) for all-cause mortality and 2. 11 (95% CI, 1. 32-3. 38) for cardiovascular events, respectively. Upon stratifying the group with both HHcy and CKD into CKD G1/2 and CKD G3 according to the KDIGO classification, both subgroups showed comparably high risks, with HRs for all-cause mortality of 2. 49 (95% CI, 1. 96-3. 18and 1. 89-3. 27, respectively) and HRs for cardiovascular events of 2. 11 (95% CI, respectively). Conclusion: In the Japanese general population aged 40 years, the coexistence of HHcy and mild-to-moderate CKD was associated with a significantly higher risk of all-cause mortality and cardiovascular events than either condition alone. I have no potential conflict of interest to disclose. I did not use generative AI and AI-assisted technologies in the writing process.
Marioli et al. (Wed,) studied this question.