Association between end-stage renal disease and abdominal aortic aneurysm: A nationwide population-based cohort study

Background Abdominal aortic aneurysm (AAA) and end-stage renal disease (ESRD), defined by need for chronic renal replacement therapy, have similar epidemiological profiles and pathogenic mechanisms. However, studies testing for a connection between these two illnesses are rare. In this research, we tested the hypothesis that there is an association between AAA and ESRD. Materials and methods Data from 2009 to 2015 were extracted from the Korean National Health Insurance Service database for this investigation. The study encompassed 16,671 individuals who had received a new AAA diagnosis. To form a control group, 50,013 participants without the disease were selected using propensity score matching based on age and sex. The primary endpoint of this study was newly diagnosed ESRD. Results The hazard ratio (HR) of ESRD incidence in the AAA group was 2.5 (95% CI 2.0-3.2); in addition, when the AAA group was divided into surgical and non-surgical groups, the HR of the non-surgical group was 2.0 (95% CI 1.5-2.6). When AAA, chronic kidney disease (CKD), and proteinuria co-occurred, the HR of ESRD incidence increased to 128.7 compared to the cases without AAA. There were interactions of diabetes mellitus (DM), CKD, and proteinuria with incidence of ESRD ( p < 0.05). In the absence of these comorbidities, the HR for ESRD was higher in the presence of AAA [1.6 vs. 3.8 (DM), 2.3 vs. 3.4 (CKD), and 1.8 vs. 3.0 (proteinuria)]. Conclusions Our findings revealed a significant association between AAA and ESRD even after adjusting for several health conditions. This discovery suggests the need for closer monitoring of kidney function in patients with AAA. This proactive approach can aid in promptly identifying signs of ESRD and addressing modifiable risk factors at an early stage through timely interventions.