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. 2020 Nov;25(11):839-844.
doi: 10.1111/nep.13745. Epub 2020 Jul 1.

Impact of cardiovascular events on mortality and progression of renal dysfunction in a Queensland CKD cohort

Andrew Jeyaruban  1   2   3 , Wendy Hoy  1   2 , Anne Cameron  1   2 , Helen Healy  1   2   3 , Zaimin Wang  1   2 , Jianzhen Zhang  1   2 , Andrew Mallett  1   2   3   4   5
Affiliations

Impact of cardiovascular events on mortality and progression of renal dysfunction in a Queensland CKD cohort

Andrew Jeyaruban et al. Nephrology (Carlton). 2020 Nov.

Abstract

Aim: Cardiovascular events (CVE) are common co-morbidities amongst patients with chronic kidney disease (CKD). The impact of CVE on the subsequent pattern and rate of deterioration of kidney function is not well described.

Methods: A retrospective cohort study of 1123 Royal Brisbane and Women's Hospital patients enrolled in the CKD.QLD registry from May 2011 to August 2017 was undertaken. Participants CVE data and renal function (eGFR CKD-EPI) were extracted from clinical records. Participants who ultimately started kidney replacement therapy (KRT) were imputed an eGFR of 8 mL/min/1.73 m2 at the date of the first KRT treatment. Annualized percentage delta eGFR was used to explore the association between CVE and rate of renal deterioration. Mortality was ascertained through electronic health records.

Results: There were 235 CVE events amongst 222 participants over a period of 6 years. One hundred and forty-four participants experienced ischaemic heart disease (IHD), 51 participants had stroke, 40 participants had peripheral vascular disease (PVD) and 13 participants had more than one event. CVE were associated with significantly shorter time to death in participants who experienced one CVE compared with those without a CVE (1901.2 days vs 2259 days [P < .05]). However, there was no significant change in the absolute mean delta eGFR between participants with CVE and without CVE after adjustment for age (3.8 mL/min/1.73 m2 vs 3.8 mL/min/1.73 m2 [P = .9]). Furthermore, there was no significant difference in the progression to KRT in participants with CVE compared with participants without CVE (1315 days and 1052 days (P = .46).

Conclusion: Cardiovascular events are associated with increased mortality in the CKD cohort. They were not associated with accelerated deterioration of kidney function.

Keywords: cardiovascular events; chronic kidney disease; delta eGFR; renal replacement therapy.

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Conflict of interest statement

The authors declare no potential conflict of interests. The results presented in this paper have not been published previously in whole or part except in abstract format.

Figures

FIGURE 1
FIGURE 1
Distribution of participants according to the CKD stages
FIGURE 2
FIGURE 2
Kaplan Meier analysis of mortality (in days) of CKD.QLD (RBWH) participants with and without cardiovascular events (CVE)
FIGURE 3
FIGURE 3
Kaplan Meier analysis of progression to kidney replacement therapy (in days) of CKD.QLD (RBWH) participants with and without cardiovascular events (CVE)
See this image and copyright information in PMC

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