Key result
Current smoking (HR 1.87), type 2 diabetes (HR 1.81), higher systolic blood pressure, lower eGFR, and higher uACR were independently associated with an elevated risk of end-stage kidney disease in patients with stable cardiovascular disease.
Why the study?
Patients with CVD are at increased risk of ESKD, and insights into its incidence and modifiable risk factors may provide means for prevention.
What are the incidence and modifiable risk factors for end-stage kidney disease in patients with stable cardiovascular disease?
Cohort (n=8,402)
No
What are the incidence and modifiable risk factors for end-stage kidney disease in patients with stable cardiovascular disease?
Answers are grounded in this paper and cite their sources.
In patients with stable cardiovascular disease, smoking, type 2 diabetes, higher systolic blood pressure, lower eGFR, and higher uACR are independent modifiable risk factors for end-stage kidney disease.
Background Patients with cardiovascular disease (CVD) are at increased risk of end-stage kidney disease (ESKD). Insights into the incidence and role of modifiable risk factors for end-stage kidney disease may provide means for prevention in patients with cardiovascular disease. Methods We included 8402 patients with stable cardiovascular disease. Incidence rates (IRs) for end-stage kidney disease were determined stratified according to vascular disease location. Cox proportional hazard models were used to assess the risk of end-stage kidney disease for the different determinants. Results Sixty-five events were observed with a median follow-up of 8.6 years. The overall incidence rate of end-stage kidney disease was 0.9/1000 person-years. Patients with polyvascular disease had the highest incidence rate (1.8/1000 person-years). Smoking (Hazard ratio (HR) 1.87; 95% CI 1.10–3.19), type 2 diabetes (HR 1.81; 95% CI 1.05–3.14), higher systolic blood pressure (HR 1.37; 95% CI 1.24–1.52/10 mmHg), lower estimated glomerular filtration rate (eGFR) (HR 2.86; 95% CI 2.44–3.23/10 mL/min/1.73 m 2 ) and higher urine albumin/creatinine ratio (uACR) (HR 1.19; 95% CI 1.15–1.23/10 mg/mmol) were independently associated with elevated risk of end-stage kidney disease. Body mass index (BMI), waist circumference, non-HDL-cholesterol and exercise were not independently associated with risk of end-stage kidney disease. Conclusions Incidence of end-stage kidney disease in patients with cardiovascular disease varies according to vascular disease location. Several modifiable risk factors for end-stage kidney disease were identified in patients with cardiovascular disease. These findings highlight the potential of risk factor management in patients with manifest cardiovascular disease. Graphic abstract
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Østergaard et al. (2021) conducted a cohort in Stable cardiovascular disease (n=8,402). Current smoking vs. Non-smoking was evaluated on End-stage kidney disease (HR 1.87, 95% CI 1.10-3.19). Current smoking (HR 1.87), type 2 diabetes (HR 1.81), higher systolic blood pressure, lower eGFR, and higher uACR were independently associated with an elevated risk of end-stage kidney disease in patients with stable cardiovascular disease.
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