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. 2017;130(1):57-63.
doi: 10.4103/0366-6999.196564.

Association of Chronic Kidney Disease with Coronary Heart Disease and Stroke Risks in Patients with Type 2 Diabetes Mellitus: An Observational Cross-sectional Study in Hangzhou, China

Xue Sun  1 , Jie He  1 , Xiao-Li Ji  1 , Yi-Ming Zhao  1 , Han-Yu Lou  1 , Xiao-Xiao Song  1 , Li-Zhen Shan  1 , Ying-Xiu Kang  1 , Wen-Heng Zeng  1 , Xiao-Hong Pang  1 , Song-Zhao Zhang  2 , Yue Ding  1 , Yue-Zhong Ren  1 , Peng-Fei Shan  1
Affiliations

Association of Chronic Kidney Disease with Coronary Heart Disease and Stroke Risks in Patients with Type 2 Diabetes Mellitus: An Observational Cross-sectional Study in Hangzhou, China

Xue Sun et al. Chin Med J (Engl). 2017.

Abstract

Background: Chronic kidney disease (CKD) is an independent risk factor for cardiovascular disease (CVD). However, the association between CKD and CVD risk in patients with type 2 diabetes mellitus (T2DM) in China has not yet been well investigated. This study aimed to determine the association of CKD with the risks of coronary heart disease (CHD) and stroke in a Chinese population with T2DM.

Methods: A total of 1401 inpatients with T2DM at the Second Affiliated Hospital of Zhejiang University School of Medicine between April 2008 and November 2013 were included in this study. The CKD-Epidemiology Collaboration equation for Asians was used to classify CKD. The UK Prospective Diabetes Study risk engine was used to estimate the risks of CHD and stroke.

Results: CHD risk was significantly increased with CKD stage (20.1%, 24.8%, and 34.3% in T2DM patients with no CKD, CKD Stage 1-2, and Stage 3-5, respectively; P < 0.001 for all). The stroke risk was also increased with CKD stage (8.6%, 12.7%, and 25.4% in T2DM patients with no CKD, CKD Stage 1-2, and Stage 3-5, respectively; P < 0.001 for all). Compared with no-CKD group, the odds ratios (OR s) for high CHD risk were 1.7 (P < 0.001) in the CKD Stage 1-2 group and 3.5 (P < 0.001) in the CKD Stage 3-5 group. The corresponding OR s for high stroke risk were 1.9 (P < 0.001) and 8.2 (P < 0.001), respectively.

Conclusion: In patients with T2DM, advanced CKD stage was associated with the increased risks of CHD and stroke.

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Conflict of interest statement

There are no conflicts of interest.

Figures

Figure 1
Figure 1
Age-related changes in risks of coronary heart disease (CHD, a) and stroke (b) according to chronic kidney disease (CKD) stage. P < 0.001 compared among age groups at the same CKD stage.
Figure 2
Figure 2
Age-related changes in risks of coronary heart disease (CHD, a) and stroke (b) according to urine albumin-to-creatinine ratio (UACR). P < 0.001 compared among age groups at the same UACR level.
See this image and copyright information in PMC

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