Key result
An increasing trajectory in ASCVD risk scores independently predicted a higher risk of incident chronic kidney disease compared to a stable trajectory (HR 1.35).
Why the study?
Atherosclerotic cardiovascular disease (ASCVD) risk scores reflect atherosclerotic burden that changes over time, but the association between ASCVD risk trajectories and incident chronic kidney disease was not established.
Does an increasing ASCVD risk trajectory predict incident CKD in individuals without baseline CKD?
Cohort (n=5,032)
Does an increasing ASCVD risk trajectory predict incident CKD in individuals without baseline CKD?
Hazard Ratio: 1.35 (95% CI 1.02–1.78)
An increasing trajectory in ASCVD risk scores independently predicts the development of incident chronic kidney disease, highlighting the link between cardiovascular risk progression and renal decline.
Background The relationship between atherosclerosis and renal function is well established. Atherosclerotic cardiovascular disease (ASCVD) risk scores reflect atherosclerotic burden, which changes over time. We investigated the association between ASCVD risk trajectories and incident chronic kidney disease (CKD) using data from a large community-based Korean cohort with up to 16 years of follow-up. Methods We analyzed data from 5032 participants without CKD from the baseline survey of the Korean Genome and Epidemiology Study Ansan-Ansung cohort. Participants were categorized into stable or increasing ASCVD risk groups based on the revised ASCVD risk pooled cohort equation over a median period of exposure of 5.8 years. Incident CKD was defined as two consecutive events of an estimated glomerular filtration rate <60 mL/min/1.73 m 2 . Results During a median 9.9 years of event accrual period, 449 (8.92%) new-onset CKD cases were identified. Multiple Cox proportional regression analyses showed that the hazard ratio (95% confidence interval) for incident CKD in the increasing group, compared to the stable group, was 2.13 (1.74–2.62) in the unadjusted model and 1.35 (1.02–1.78) in the fully-adjusted model. Significant relationships were maintained in subgroups of individuals in their 50s, without diabetes mellitus or hypertension. The prevalence of proteinuria was consistently higher in the increasing group than that in the stable group. Conclusions An increasing trend in ASCVD risk scores independently predicted adverse renal outcomes. Continuous monitoring of ASCVD risk is not only important for predicting cardiovascular disease but also for predicting CKD.
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Lee et al. (2023) conducted a cohort in Chronic kidney disease (n=5,032). Increasing ASCVD risk trajectory vs. Stable ASCVD risk trajectory was evaluated on Incident chronic kidney disease (two consecutive events of eGFR <60 mL/min/1.73 m2) (HR 1.35, 95% CI 1.02-1.78). An increasing trajectory in ASCVD risk scores independently predicted a higher risk of incident chronic kidney disease compared to a stable trajectory (HR 1.35).
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