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Chronic kidney disease and 10-year risk of cardiovascular death
Karolinska Univ Hosp, Dept Emergency Med, Huddinge, Sweden.;Karolinska Inst, Dept Internal Med, Huddinge, Sweden..
Karolinska Inst, Div Family Med, Dept Neurobiol Care Sci & Soc, Huddinge, Sweden.;Karolinska Inst, Inst Environm Med, Div Cardiovasc Epidemiol, Huddinge, Sweden..
Karolinska Inst, Inst Environm Med, Div Cardiovasc Epidemiol, Huddinge, Sweden..
Karolinska Univ Hosp, Dept Cardiothorac Surg & Anesthesiol, Stockholm, Sweden.;Karolinska Inst, Dept Mol Med & Surg, Huddinge, Sweden..
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2016 (English)In: European Journal of Preventive Cardiology, ISSN 2047-4873, E-ISSN 2047-4881, Vol. 23, no 11, 1187-1194 p.Article in journal (Refereed) Published
Abstract [en]

Background In recent clinical guidelines, individuals with chronic kidney disease are considered to have a similar 10-year absolute risk of cardiovascular death as individuals with diabetes or established cardiovascular disease. There is limited evidence to support this claim. Methods We investigated the 10-year risk for cardiovascular death in individuals with moderate or severe chronic kidney disease (glomerular filtration rate of 30-60 or <30mL/min/1.73m(2), respectively) in a cohort of primary care health check-ups in Stockholm, Sweden (n=295,191, 46% women, 4290 cardiovascular deaths during 10 years follow-up). We also assessed the risk associated with diabetes or cardiovascular disease. The inclusion criteria, exposure, study outcome and follow-up period adhered strictly to the definitions of the European Society of Cardiology guidelines. Results The absolute 10-year risk of cardiovascular death was 3.9% and 14.0% in individuals with moderate and severe chronic kidney disease, respectively, but was substantially lower in women and in younger individuals. The risk in individuals with prevalent diabetes and cardiovascular disease was approximately two and three times higher compared to the risk estimate for moderate chronic kidney disease (hazard ratio (HR) 4.1, 95% confidence interval (CI) 3.8-4.5 and HR 6.2, 95% CI 5.7-6.7 vs. HR 2.3 95% CI 2.0-2.6, respectively) while the risk for individuals with severe chronic kidney disease appeared more congruent to that of diabetes and cardiovascular disease (HR 5.5, 95% CI 3.3-8.9). Conclusions Although moderate chronic kidney disease is an independent predictor for an increased 10-year risk of cardiovascular death, only those with severe chronic kidney disease had similar risk to those with diabetes or cardiovascular disease.

Place, publisher, year, edition, pages
2016. Vol. 23, no 11, 1187-1194 p.
Keyword [en]
Kidney disease, ESC guidelines, risk, cardiovascular death
National Category
Urology and Nephrology
Identifiers
URN: urn:nbn:se:uu:diva-305948DOI: 10.1177/2047487315614491ISI: 000380922600009PubMedID: 26541858OAI: oai:DiVA.org:uu-305948DiVA: diva2:1044478
Funder
Swedish Research CouncilSwedish Heart Lung FoundationMarianne and Marcus Wallenberg Foundation
Available from: 2016-11-03 Created: 2016-10-24 Last updated: 2016-11-03Bibliographically approved

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Ärnlöv, Johan
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Molecular epidemiologyScience for Life Laboratory, SciLifeLab
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